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18 Cards in this Set
- Front
- Back
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What can cirrhosis cause?
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Portal HTN
Encephalopathy Renal Failure Death |
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Causes of Cirrhosis
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1. Chronic Viral Hepatitis (BCD)
2. Toxins and Drugs(booze) 3. Hemochromatosis 4. Wilson's 5. Alpha1-antitrypsin Def 6. PBC and PSC 7. Venous Outflow Obstruction (budd-C, occlusive stuff) 8. NASH and NAFL |
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What happens to a normal liver before it starts cirrhosising?
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it gets inflamed!@
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What is the regenerative capacity of the liver?
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It can bounce back from Infl, but not cirrhosis
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what is the gold standard of cirrhosis dx?
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biopsy
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Complications of Cirrhosis
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Ascites
Varices Encephalopathy Cancer |
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Ascites is usually secondary to?
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80% 2ndary to PHTN
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Mortality?
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50% die in 2 yrs w/o rx
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What can cause abd distention?
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5 F's
Fat Flatus Fetus Fluid Feces |
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Rx for Ascites
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1. Fluid Restriction
2. No added salt 3. Diuretics (spiralactone) 4. Large volume paracentesis 5. TIPSS (big shunt) 6. Liver Transplant |
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Complications of Ascites
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Peritonitis (dx by polymorphs in fluid)
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Rx of Peritonitis
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Ceftrioxone
IV infusion of albumin Long-term AB use |
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What causes varices?
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Increased portal pressure
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Rx for Variceal Bleeding
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Somatostatin
Endoscopic (injection of sclerosing agents or ligation) Ballon Tamponade TIPSS |
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How do you perform a TIPSS?
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shunt from portal vein to IVC
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What is the problem with TIPSS?
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Encephalopathy due to the decreased detox of blood.
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Features of Hepatic Encephalopathy
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Dec Concentration
Worsening handwriting Flapping Tremor of hands Fetor (breath smell) Altered sleep pattern |
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Management of Encephalopathy
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Discontinue Sedatives
Correct electrolytes and glucose Reduce dietary protein Look for infections and rx Nurse pt with head elevated Lactulose in NG tube (-->diarrhea) |
