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11 Cards in this Set

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  • Back
Cirrhosis is most frequently caused by
Hepatitis C
Alcoholism
the most common complication of cirrhosis is
Ascites
Conditions associated with severe renal or circulatory dysfunction
Refractory ascites
spontaneous bacterial peritonitis
hepatorenal syndrome
Diagnostics for patients with cirrhosis and ascites
LFT and Coags
ABd ultrasound or ct
Upper GI endoscopy (to eval for gastroesophageal varices)
Possible liver biopsy (if cause or type)
Characteristics of Dilutional hyponatremia
serum sodium less than 130 mmol per liter
with ascites and/or edema
Management of dilutional hyponatremia includes
low sodium diet
Fluid restriction 1000ml/day
Management of moderate-volume ascites includes
Diuretic therapy
spironolactone 50 - 200 mg/day
or amiloride 5 - 10 mg/day
may add Lasix 20 -40 mg for the first few days if peripheral edema is present.
Caution to avoid excessive diuresis resulting in renal failure.
characteristics of refractory ascites
ascites that does not respond to high dose diuretics
large volume ascites characteristics
enough volume to cause marked abd distention and interferes with the regular daily activities
pt may present with severe sodium retention
Characteristics of hepatic encephalopathy
changes in level of consciousness,
reflexes
and behavior
Coarse, "flapping" muscle tremor may be observed during voluntary movement, such as when the person attempts to hold the arms out in front of the body (also exhibited as a positive Babinski's reflex).
precipitating facotrs of hepatic encephalopathy
gi bleed,
excessive diuresis,
infection