Transplant-Liver Key Words

Question 1

Asterixis

Answer 1

a disorder in which a person loses motor control of some parts of the body. It is commonly called flapping hand tremor because the muscles in the fingers and the wrists are typically affected.

Test: Hands outstretched, fingers spread, eyes closed

Question 2

Hydroxyzine

Answer 2

This drug is used to treat itching from jaundice

Question 3

Lactulose

Answer 3

This drug is used by mouth or rectally to treat or prevent complications of liver disease (hepatic encephalopathy).
Goal: 3-4 bowel movements per day

Question 4

Naltrexone

Answer 4

This drug is used to treat both alcohol use disorder (AUD) and opioid use disorder (OUD)

Question 5

Xifaxan (Rifaximin)

Answer 5

This drug is used to prevent complications of liver disease (hepatic encephalopathy)

Question 6

Two drugs used to prevent complications of liver disease (hepatic encephalopathy)

Answer 6

(1) Lactulose

(2) Xifaxan (Rifaximin)

Question 7

Thiamine

Answer 7

Vitamin B1
Used to prevent muscle loss, neuropathy

Question 8

Furosemide (lasix)

Answer 8

This drug is a strong diuretic (‘water pill’) and may cause dehydration and electrolyte imbalance

Question 9

Spironolactone (Aldactone)

Answer 9

This drug is a potassium-sparing diuretic (water pill)

Question 10

TIPS

Answer 10

Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure that involves inserting a stent (tube) to connect the portal veins to adjacent blood vessels that have lower pressure. This relieves the pressure of blood flowing through the diseased liver and can help stop bleeding and fluid back up.

Question 11

Vitamin considerations

Answer 11

(1) Thiamine
(2) Magnesium
(3) Potassium
(4) Folic Acid
(5) multivitamin

Question 12

Vaccine considerations

Answer 12

(1) flu
(2) COVID
(3) pneumonia
(4) Hep A

Question 13

Paracentesis considerations

Answer 13

(1) total fluid removal (recommend 8L max)
(2) albumin IV with treatment

Question 14

Why give albumin with paracentesis?

Answer 14

prevent circulatory dysfunctions after large-volume paracentesis

Question 15

Tylenol in Liver disease

Answer 15

2,000 mg daily max

Question 16

Complications of Cirrhosis

Answer 16

Catabolic Disease
(1) Ascites

— (a) treat with diuretics

—(b) low salt diet (2g)

—(c) paracentesis

(2) Hepatic encephalopathy

—(a) Xifaxan (Rifaximin)

—(b) Lactulose

(3) Esophageal varices
(4) Liver cancer
(5) Sarcopenia (muscle wasting)

Question 17

Ways to treat ascites

Answer 17

— (a) treat with diuretics

—(b) low salt diet (2g)

—(c) paracentesis

Question 18

Ways to treat/prevent hepatic encephalopathy

Answer 18

—(a) Xifaxan (Rifaximin)

—(b) Lactulose

Question 19

Recommended diet for prevention of Sarcopenia (muscle wasting)

Answer 19

1. 4-5 meals per day (increase protein)
2. bedtime snack
3. Dietician performs frailty testing
4. Low sodium diet (2g)

Question 20

Sodium diet guidlines

Answer 20

No more than 2g per day

Question 21

cachectic

Answer 21

loss of weight, muscle atrophy, fatigue, weakness and significant loss of appetite in someone who is not actively trying to lose weight.

Question 22

Jaundice is visible in conjunctiva, skin, and mucosa when the serum bilirubin level rises above 2 mg/dL

Answer 22

Jaundice is visible in conjunctiva, skin, and mucosa when the serum bilirubin level rises above 2 mg/dL

Question 23

Where does jaundice first appear?

Answer 23

mucosa under the tongue