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OST 575 Exam 3 Cirrhosis With Complete Solution
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OST 575 Exam 3 Cirrhosis With Complete SolutionDistortion of the hepatic vasculature causing shunting of portal and arterial blood
supply directly into hepatic outflow (central veins) and the compromise of exchange
between hepatic sinusoids and the adjacent liver parenchyma (i.e hepatocytes) is
characteristic of what liver disorder? - ANSWER Liver cirrhosis
What are the clinical consequences of liver cirrhosis? - ANSWER impaired *hepatocyte*
function
increased intrahepatic resistance (portal hypertension)
development of *hepatocellular carcinoma (HCC)*
What are the major complications of Liver cirrhosis? - ANSWER variceal hemorrhage
Ascites
Spontaneous bacterial peritonitis
hepatic encephalopathy
hepatocellular carcinoma
How does portal hypertension occur? - ANSWER increase in hepatic venous pressure
gradient
increase in resistance to portal venous outflow
What is the term used to describe the accumulation of fluid within the peritoneal cavity?
- ANSWER Ascites (MOST common complication of cirrhosis)
How do ascites develop? - ANSWER development of *portal hypertension* causes
sodium retention which leads to FLUID retention
, What is the term used to describe an infection of pre-existing ascitic fluid WITHOUT
evidence for an intra-abdominal secondary source, such as a *perforated viscous*? -
ANSWER Spontaneous bacterial peritonitis
When is spontaneous bacterial peritonitis most commonly seen? - ANSWER in setting of
END-stage liver disease
What are the clinical manifestations of Spontaneous bacterial peritonitis? - ANSWER
fever
abdominal pain
altered mental status
What is the most common bacterial cause of Spontaneous bacterial peritonitis? -
ANSWER E. coli
How can one tell the difference between spontaneous bacterial peritonitis and a
perforated viscous? - ANSWER perforated viscous = more than 2 bacterial organisms
found
spontaneous bacterial peritonitis = 1 bacteria
How does one diagnose and treat spontaneous bacterial peritonitis? - ANSWER Ascite
fluid bacterial culture OR elevated ascitic fluid absolute PMN leukocyte count (>250)
*antibiotic treatment*
What is Hepatorenal syndrome? - ANSWER development of renal failure in a patient with
advanced liver disease due to cirrhosis, severe alcoholic hepatitis, acute liver failure, or
even a metastatic tumor
What plays a central role in the hemodynamic changes and decline in renal function in
hepatorenal syndrome? - ANSWER Arterial vasodilation in *splanchnic circulation*
triggered by portal hypertension
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