Liver Cirrhosis

a chronic liver disease that causes liver failure. It includes widespread fibrosis causing death of hepatocytes and spasms of hepatic blood vessels

alcoholism, chronic hepatitis B and C, NASH, autoimmune hepatitis, drugs/toxins, biliary cirrhosis, metabolic disease, cardiac cirrhosis, idiopathic cause

cirrhosis where the cause is idiopathic

the liver is still working enough to fulfill its basic functions

has signs of liver failure and is a sign of advanced damage to the liver

decreased number of hepatocytes, portal hypertension, a combined issue

effects of portal hypertension

decreased appetite, weight loss, fatigue, bleeds, signs of portal hypertension, irritation if the cause is biliary

jaundice, ecchymosis, spider angioma, dupuytren's contractures, clubbing, atrophy, gynecomastia, ascites

refers to the discoloration of the skin due to the rupture of the blood vessels below the surface of the skin.

a small red to purple mark on your skin caused by dilated (wide) blood vessels (capillaries) near the surface of your skin.

inability to straighten fingers because a tendon was shortened

increase in portal bp above 10mmHg it occurs in 60% of cirrhosis patients

caused by portal hypertension. The blood has know way to get to the IVC through the portal system and so therefore it tries to go through the vessels in the esophagus leading to widened esophageal veins

test used to diagnose esophageal varices

bloody vomit, coffee ground vomit, melena, hypovolemic shock, hypotension

hemodynamic balance, giving fluids and electrolytes, vasopressin, octreotide, blakemore tube, non selective beta blockers, TIPS

tube with two balloons used to put pressure on varices in order to stop them from bleeding

gateway treatment until a liver transplant can be performed. It is a shunt between the hepatic and portal veins in order to relieve pressure from the portal vein

caused by portal hypertension. It will lead to increased breakdown of blood cells and pancytopenia

decreased levels of all types of blood cells

build up of fluid in the peritoneum. On a physical exam there will be shifting dullness and תנועות גל

draining of the fluid, limit of salt to up to 2g/day, aldactone, large volume paracentesis and IV albumin

infection of the ascites fluid because of a bacteria. Usually occurs in patients who have liver cirrhosis in addition to ascites

what is the main sign that should make you include SBP in your differential diagnosis

shortness of breath that is caused by large amounts of ascites fluid

sudden decline in kidney function as a result of liver cirrhosis and ascites. There will be oliguria, increased BUN/creatinine, azotemia, hypotension

GI bleed, sepsis, aggressive draining of ascites fluid

damage to brain function caused by severe liver failure because it isn't filtering out toxins.

asterixis, decreased mental status, problems in behavior, personality, and motor functions

treatment of the cause, lactulose, rifamixin, liver transplants

coagulopathy, inability to maintain proper sugar levels, hepatocellular carcinoma