NSG 4330 Liver Disease Pt 2: Cirrhosis and
|\ |\ |\ |\ |\ |\ |\ |\
hepatic encephalopathy questions with |\ |\ |\ |\
answers
What is liver cirrhosis?
|\ |\ |\
chronic, progressive fibrosis of liver. Extensive degeneration and
|\ |\ |\ |\ |\ |\ |\ |\
destruction of liver parenchymal cells and normally regenerative
|\ |\ |\ |\ |\ |\ |\ |\
nodules. Final stage of chronic liver disease.
|\ |\ |\ |\ |\ |\
What are the most common causes of liver cirrhosis?
|\ |\ |\ |\ |\ |\ |\ |\
alcohol misuse, chronic viral HCV HBV, any other chronic liver
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
diseases
What are the two rare causes of cirrhosis?
|\ |\ |\ |\ |\ |\ |\
hereditary hemochromatosis (genetic disorder impacting liver
|\ |\ |\ |\ |\ |\
heart pancreas), NAFLD
|\ |\
Early (compensated) manifestations of liver cirrhosis
|\ |\ |\ |\ |\
abrupt GI symptoms |\ |\
altered metab of CHO, fats, proteins.
|\ |\ |\ |\ |\
Anorexia, dyspepsia, flatulence, nausea/vomiting, changes to
|\ |\ |\ |\ |\ |\
bowel habits |\
Fever, lassitude, weight loss, hepato/splenomegaly, palpable
|\ |\ |\ |\ |\ |\
liver, pain in RUQ or epigastrium, muscle loss, asterixis (flapping
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
tremor)
Late stage cirrhosis signs
|\ |\ |\
Jaundice, peripheral edema, ascites, skin lesions (spider
|\ |\ |\ |\ |\ |\ |\
angiomas)
hematologic/coagulation disorders |\
endocrine disturbances |\
, hyperaldosteronism.
Liver becomes small and nodular, fibrotic and dysfunctional.
|\ |\ |\ |\ |\ |\ |\
Endocrine disturbances in men vs women in cirrhosis
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estrogen accumulation in men, vag bleeding in women
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Why does hyperaldosteronism occur with cirrhosis?
|\ |\ |\ |\ |\
liver cannot metabolize aldosterone properly, sodium
|\ |\ |\ |\ |\
retention/water retention/potassium loss, peripheral
|\ |\ |\ |\ |\
neuropathies
Why do hematological disturbances occur in cirrhosis?
|\ |\ |\ |\ |\ |\
the patient is unable to produce Prothrombin in the liver
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What are the 4 complications of cirrhosis?
|\ |\ |\ |\ |\ |\
Portal hypertension |\
esophageal varices |\
peripheral edema |\
ascites
Portal hypertension |\
Increased venous pressure in portal circulation, collateral
|\ |\ |\ |\ |\ |\ |\
circulation forms in esophagus (low pressure venous system) to
|\ |\ |\ |\ |\ |\ |\ |\ |\
reduce pressure. |\
Esophageal varices |\
enlarged and swollen veins at the lower end of the esophagus
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Fragile and do not tolerate high pressures well. 20% mortality
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
over 5 years.
|\ |\
patho of Peripheral edema in cirrhosis
|\ |\ |\ |\ |\
Decreased colloidal oncotic pressure causes edema, fluid not
|\ |\ |\ |\ |\ |\ |\ |\
reabsorbed into bloodstream. |\ |\
patho of Ascites in cirrhosis
|\ |\ |\ |\
|\ |\ |\ |\ |\ |\ |\ |\
hepatic encephalopathy questions with |\ |\ |\ |\
answers
What is liver cirrhosis?
|\ |\ |\
chronic, progressive fibrosis of liver. Extensive degeneration and
|\ |\ |\ |\ |\ |\ |\ |\
destruction of liver parenchymal cells and normally regenerative
|\ |\ |\ |\ |\ |\ |\ |\
nodules. Final stage of chronic liver disease.
|\ |\ |\ |\ |\ |\
What are the most common causes of liver cirrhosis?
|\ |\ |\ |\ |\ |\ |\ |\
alcohol misuse, chronic viral HCV HBV, any other chronic liver
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
diseases
What are the two rare causes of cirrhosis?
|\ |\ |\ |\ |\ |\ |\
hereditary hemochromatosis (genetic disorder impacting liver
|\ |\ |\ |\ |\ |\
heart pancreas), NAFLD
|\ |\
Early (compensated) manifestations of liver cirrhosis
|\ |\ |\ |\ |\
abrupt GI symptoms |\ |\
altered metab of CHO, fats, proteins.
|\ |\ |\ |\ |\
Anorexia, dyspepsia, flatulence, nausea/vomiting, changes to
|\ |\ |\ |\ |\ |\
bowel habits |\
Fever, lassitude, weight loss, hepato/splenomegaly, palpable
|\ |\ |\ |\ |\ |\
liver, pain in RUQ or epigastrium, muscle loss, asterixis (flapping
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
tremor)
Late stage cirrhosis signs
|\ |\ |\
Jaundice, peripheral edema, ascites, skin lesions (spider
|\ |\ |\ |\ |\ |\ |\
angiomas)
hematologic/coagulation disorders |\
endocrine disturbances |\
, hyperaldosteronism.
Liver becomes small and nodular, fibrotic and dysfunctional.
|\ |\ |\ |\ |\ |\ |\
Endocrine disturbances in men vs women in cirrhosis
|\ |\ |\ |\ |\ |\ |\
estrogen accumulation in men, vag bleeding in women
|\ |\ |\ |\ |\ |\ |\
Why does hyperaldosteronism occur with cirrhosis?
|\ |\ |\ |\ |\
liver cannot metabolize aldosterone properly, sodium
|\ |\ |\ |\ |\
retention/water retention/potassium loss, peripheral
|\ |\ |\ |\ |\
neuropathies
Why do hematological disturbances occur in cirrhosis?
|\ |\ |\ |\ |\ |\
the patient is unable to produce Prothrombin in the liver
|\ |\ |\ |\ |\ |\ |\ |\ |\
What are the 4 complications of cirrhosis?
|\ |\ |\ |\ |\ |\
Portal hypertension |\
esophageal varices |\
peripheral edema |\
ascites
Portal hypertension |\
Increased venous pressure in portal circulation, collateral
|\ |\ |\ |\ |\ |\ |\
circulation forms in esophagus (low pressure venous system) to
|\ |\ |\ |\ |\ |\ |\ |\ |\
reduce pressure. |\
Esophageal varices |\
enlarged and swollen veins at the lower end of the esophagus
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Fragile and do not tolerate high pressures well. 20% mortality
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
over 5 years.
|\ |\
patho of Peripheral edema in cirrhosis
|\ |\ |\ |\ |\
Decreased colloidal oncotic pressure causes edema, fluid not
|\ |\ |\ |\ |\ |\ |\ |\
reabsorbed into bloodstream. |\ |\
patho of Ascites in cirrhosis
|\ |\ |\ |\
