Term
| most common cause of cirrhosis: |
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Definition
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|
Term
| most common age of cirrhosis: |
|
Definition
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Term
| increasing resistance to blood flow through the liver leads to:5 |
|
Definition
1. portal HTN
2. hemorrhoids/esophageal varices
3. peripheral edema/ascites
4. peritonitis
5. hepatic encephalopathy |
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Term
|
Definition
1. fatty liver or enlargement
2. fibrosis
3. cirrhosis |
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Term
|
Definition
1. postnecrosis (inf or Rx induced)
2. Alcoholic (etoh + malnutrition)
3. Biliary (biliary obstruction) |
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Term
| cardiac complications of cirrhosis: |
|
Definition
1. chronic right sided heart failure
2. tricuspid regurgitation |
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Term
| clinical presentation of cirrhosis:6 |
|
Definition
1. anorexia,wt loss,fatigue,muscle waste
2. hepatosplenomegaly
3. increased bruising bleeding
4. skin manefestations 7
5. gynecomastia/impotence (manboobs/testes atrophy)
6. loss of axillary/pubic hair |
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|
Term
| cutaneous manifestations of cirrhosis:5 |
|
Definition
1. pruritis
2. jaundice
3. spider telangectasia
4. palmar erythema
5. white nails/no lunula |
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Term
| fast, inexpensive detection of ascities, cirrhosis: |
|
Definition
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Term
| indicated lab for hepatic encephalopathy: |
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Definition
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Term
| 3 zebras for cirrhosis work up: |
|
Definition
1. Autoimmune
2. Wilsons dz
3. a-1-AT def |
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Term
| lab for hepatocellular CA: |
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Definition
|
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Term
| what would a CMP look like in Cirrhosis? |
|
Definition
elevated Liver enzymes
decreased Glu
elevated total bilirubin
decreased total protein |
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Term
| what maight a PT/PTT look like for cirrhosis: |
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Definition
| elevated due to lack to vitamin K dependant coag factors (decreased proteins produced from the liver) |
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Term
| why would you advise cirrhotic pts not to lift heavy objects: |
|
Definition
| valsalva manuveur causing increased blood flow to a cirrhotic liver increasing ascites/varices |
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Term
|
Definition
1. salt reduction
2. paracentesis
3. surgery w bowel incarceration
4. herniorrhaphy
5. peritoneovenous shunt
6. portosystemic shunt |
|
|
Term
|
Definition
Trans-jugular
Intrahepatic
Portosystemic
Shunt
(stent placement in portal vein) |
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Term
| 4 complications of cirrhosis: |
|
Definition
1. ascites
2. peritonitis
3. variceal bleed
4. hepatic encephalopathy |
|
|
Term
|
Definition
1. IV fluids
2. Transfusion if indicated
3. Balloon tamponade |
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|
Term
| prevention of variceal bleeding:4 |
|
Definition
1. avoid NSAIDs
2. B-blockers
3. ligations
4. portosystemic shunts |
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Term
| DOC for hepatic encephalopathy: |
|
Definition
| Lactulose; stimulates passage of ammonia into GI from tissues |
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Term
| hepatic encephalopathy sx:4 |
|
Definition
1. personality changes
2. decreased short term mem
3. liver flap (tremor)
4. breath of the dead |
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Term
| factors that may precipitate hepatic encephalopathy: 5 |
|
Definition
1. diuretic therapy
2. renal fail
3. GI bleed (increased amino breakdown)
4. constipation
5. infection |
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Term
| 50-80% mortality rate w cirrhosis, unless: |
|
Definition
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Term
| Child-Turcotte-Pugh Scorring sys: |
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Definition
| predicts life expectancy in patients w advanced cirrhosis |
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|
Term
| Child-Turcotte-Pugh Class A,B,C |
|
Definition
A: 5-6pts - good , candidate for xplant
B: 7-9pts - hospitalize, shorter life expectancy
C: 10-15pts - ICU 50% chance of death wn 1yr |
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Term
| explain scoring for Child-Turcotte-Pugh: |
|
Definition
Grade 1-3 for each of the following and total:
1. encephalopathy
2. ascites
3. bilirubin 2-3 = 2pts
4. Albumin 2.8-3.5 = 2pts
5. PT 4-6 = 2pts |
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