Term
|
Definition
advanced stage of liver fibrosis
scarred and formation of fibrous bands
shunting of blood supply |
|
|
Term
|
Definition
chronic alcohol use
viral hepatitis B,C,D
metabolic liver disease
immune diseases
vascular disease
med induced |
|
|
Term
|
Definition
may be asymptomatic
heptatomegaly
encephalopathy
malaise, weight loss
pruritis, jaundice, dark skin
ascites, edema
resp difficulty
gynecomastia, decr libido |
|
|
Term
|
Definition
aminotransferases-AST, ALT
alkaline phosphatase
gamma-glutamyl transpeptidase
bilirubin
albumin
coag factors |
|
|
Term
| child-pugh classification systems |
|
Definition
calculated by adding scores from 5 factors.
for dose adjustments for hepatically cleared drugs |
|
|
Term
|
Definition
|
|
Term
| cause of portal HtN and varices |
|
Definition
| alcohol induced cirrhosis |
|
|
Term
|
Definition
hepatic venous pressure gradient between portal and central veins
greater than or equal to 5 mmHg |
|
|
Term
| primary prohylaxis portal HTN and varices tx |
|
Definition
-nonselective beta-blockers (propranolol, nadolol)
-EGD monitor for varices after cirrhosis dx
-endoscopic variceal ligation (EVL)if CI for beta-blockers and 1stline for high risk pts |
|
|
Term
| acute variceal hemmorrhage tx |
|
Definition
-blood volume resuscitation-blood products, colloids
-protect airway
-FFP/platelets for coagulopathy/thrombocytopenia
-prophy for SBP, infections-ABX
-Octreotide, vasopressin-vasocontrictors
-prevent rebleed-EVL & betablocker
-preserve liver fxn |
|
|
Term
|
Definition
synthetic somatostatin
for acute variceal hemmorrhage
no difference btwn vasopressin as vasoconstrictor |
|
|
Term
|
Definition
antidiuretic hormone
nonselective vasocontrictor for acure variceal hemorrhage
IV
not 1st line |
|
|
Term
| 2 surgery for acute variceal hemorrhage |
|
Definition
1-balloon tamponade
2-transjugular intraheptaic pprtosystemic shunt (TIPS) |
|
|
