NR574 FINAL EXAM, Week 1 Content GI/GU Emergencies
Test.
1. Hepatorenal syndrome (HRS) functional form of renal failure that
oc- curs primarily in pt with cirrhosis
and as- cites.
2. Type 1 hepatorenal syndrome is -rapidly progressive renal
character- ized by... impairment
-doubling of initial serum Cr to
greater than 2.5mg/dL over a period
less than 2 weeks
-without liver transplant prognosis is
3. Type 2 hepatorenal syndrome is very poor
character- ized by...
-moderate form of renal failure
-serum Cr levels between 1.5 to 2.5
mg/dL
reduction in GFR with elevation in
serum creatinine
-associated with a more indolent
course and improved survival
compared to type 1
4. Risk Factors of hepatorenal syndrome Dilutional hyponatremia
Previous episodes of
ascites Presence of
esophageal varices Poor
nutritional status
Infections such as spontaneous
bacterial peritonitis
Severe urinary sodium retention
(urine sodium < 5
milliequivalents/liter [mEq/L])
Large-volume paracentesis without
albu- min replacement
,NR574 FINAL EXAM, Week 1 Content GI/GU Emergencies
Test.
Acute alcoholic hepatitis
, NR574 FINAL EXAM, Week 1 Content GI/GU Emergencies
Test.
Low mean arterial blood pressure
(map
<80 mm Hg)
5. subjective clinical presentation of
hepatore- nal syndrome Most clients with HRS have a
known di- agnosis of acute or
chronic liver disease and present
with nonspecific symptoms
including:
-dysgeusia (altered taste perception)
-malaise
-fatigue
-decreased urine output.
6. objective clinical presentation of hepatorenal HRS has no characteristic
physical exam
syndrome findings.
It is important to assess the client for stig-
mata of chronic liver disease
including:
-spider nevi
-scleral icterus
-lower extremity edema
-asterixis
-abdominal distention
-fluid wave
-paraumbilical hernia
-bruits.
7. Dx criteria in hepatorenal syndrome 1. cirrhosis with ascites
2. increase in Cr >0.3 mg/dL
within 48 hrs or >50% increase
from baseline within a 7 day
, NR574 FINAL EXAM, Week 1 Content GI/GU Emergencies
Test.
period
3. no response to a 2 consecutive
day di- uretic withdrawal and
volume expansion w/ albumin
1g/kg body wt
Test.
1. Hepatorenal syndrome (HRS) functional form of renal failure that
oc- curs primarily in pt with cirrhosis
and as- cites.
2. Type 1 hepatorenal syndrome is -rapidly progressive renal
character- ized by... impairment
-doubling of initial serum Cr to
greater than 2.5mg/dL over a period
less than 2 weeks
-without liver transplant prognosis is
3. Type 2 hepatorenal syndrome is very poor
character- ized by...
-moderate form of renal failure
-serum Cr levels between 1.5 to 2.5
mg/dL
reduction in GFR with elevation in
serum creatinine
-associated with a more indolent
course and improved survival
compared to type 1
4. Risk Factors of hepatorenal syndrome Dilutional hyponatremia
Previous episodes of
ascites Presence of
esophageal varices Poor
nutritional status
Infections such as spontaneous
bacterial peritonitis
Severe urinary sodium retention
(urine sodium < 5
milliequivalents/liter [mEq/L])
Large-volume paracentesis without
albu- min replacement
,NR574 FINAL EXAM, Week 1 Content GI/GU Emergencies
Test.
Acute alcoholic hepatitis
, NR574 FINAL EXAM, Week 1 Content GI/GU Emergencies
Test.
Low mean arterial blood pressure
(map
<80 mm Hg)
5. subjective clinical presentation of
hepatore- nal syndrome Most clients with HRS have a
known di- agnosis of acute or
chronic liver disease and present
with nonspecific symptoms
including:
-dysgeusia (altered taste perception)
-malaise
-fatigue
-decreased urine output.
6. objective clinical presentation of hepatorenal HRS has no characteristic
physical exam
syndrome findings.
It is important to assess the client for stig-
mata of chronic liver disease
including:
-spider nevi
-scleral icterus
-lower extremity edema
-asterixis
-abdominal distention
-fluid wave
-paraumbilical hernia
-bruits.
7. Dx criteria in hepatorenal syndrome 1. cirrhosis with ascites
2. increase in Cr >0.3 mg/dL
within 48 hrs or >50% increase
from baseline within a 7 day
, NR574 FINAL EXAM, Week 1 Content GI/GU Emergencies
Test.
period
3. no response to a 2 consecutive
day di- uretic withdrawal and
volume expansion w/ albumin
1g/kg body wt
