This helped me...thought it will help some you as well.Goodluck studying!
Complications of Cirrhosis:
1.Hepatic failure:
1. Hypoalbuminemia: → pitting edema, ascites
2. No clotting factors: → Hemorrhages
3. Defective Urea cycle→Increased serum NH3 ammonia, which is reabsorbable → encephalopathy
[methods to reduce ammonia= low protein intake, stop taking any meds that destroy colonic bacteria. Take Lactulose, it releases H ions, causing NH3→NH4 ammonium which is not reabsorbed and is excreted in feces.]
2. Portal Hypertension
Intrasinusoidal HTN from regenerative nodule compression.
Splenic v + SMV= Portal v
1. Ascites
2. Congestive SPM: ^P in splenic V, cytopenias
3. Esophageal varices
4. Hemmorrhoids
5. Periumbilcal caput medusae
Shunts: bypass liver→ can ppt encephalopathy
* portocaval: portal v + IVC
* mesocaval: SMV+ portal v
* splenorenal: Splenic v + Renal v [most physiologic shunt, doesn't bypass liver]
* TIPS: portal v + hepatic v
3.Ascites: Abd distension, fluid wave, increased risk of spontaneous peritonitis.
1. Portal hypertension
2. Hypoalbuminemia
3. 2* hyperaldosteronism: due to low COutput→ + RAA, liver unable to meta aldosterone
[Serum albumin - Ascitic fluid albumin= tells you origin of ascites]
LIVER ascites
Transudate = protein < 2.5g/dl
WBC<300 + neutrophils< 25%
Difference of > 1.1g/dl
PERITONEAL ascites
Exudate = protein >2.5g/dl
WBC> 300+ neutrophils>25%
Diff of <1.1g/dl
4.Hepatorenal syndrome:Reversible renal failure w/0ut renal parenchymal disease
Low RBF→ increase BUN & Cr leading to Creatinine Clearance <40ml/min
5.Hyperestrinism in males:
Liver can't degrade estrogen and 17-ketosteroids leading to increased androstendione.
Androstendione aromatized to estrogen in Adipose tissue:
1. Gynecomastia
2. Spider telangiectasia
3. Female distribution of hair
Complications of Cirrhosis:
1.Hepatic failure:
1. Hypoalbuminemia: → pitting edema, ascites
2. No clotting factors: → Hemorrhages
3. Defective Urea cycle→Increased serum NH3 ammonia, which is reabsorbable → encephalopathy
[methods to reduce ammonia= low protein intake, stop taking any meds that destroy colonic bacteria. Take Lactulose, it releases H ions, causing NH3→NH4 ammonium which is not reabsorbed and is excreted in feces.]
2. Portal Hypertension
Intrasinusoidal HTN from regenerative nodule compression.
Splenic v + SMV= Portal v
1. Ascites
2. Congestive SPM: ^P in splenic V, cytopenias
3. Esophageal varices
4. Hemmorrhoids
5. Periumbilcal caput medusae
Shunts: bypass liver→ can ppt encephalopathy
* portocaval: portal v + IVC
* mesocaval: SMV+ portal v
* splenorenal: Splenic v + Renal v [most physiologic shunt, doesn't bypass liver]
* TIPS: portal v + hepatic v
3.Ascites: Abd distension, fluid wave, increased risk of spontaneous peritonitis.
1. Portal hypertension
2. Hypoalbuminemia
3. 2* hyperaldosteronism: due to low COutput→ + RAA, liver unable to meta aldosterone
[Serum albumin - Ascitic fluid albumin= tells you origin of ascites]
LIVER ascites
Transudate = protein < 2.5g/dl
WBC<300 + neutrophils< 25%
Difference of > 1.1g/dl
PERITONEAL ascites
Exudate = protein >2.5g/dl
WBC> 300+ neutrophils>25%
Diff of <1.1g/dl
4.Hepatorenal syndrome:Reversible renal failure w/0ut renal parenchymal disease
Low RBF→ increase BUN & Cr leading to Creatinine Clearance <40ml/min
5.Hyperestrinism in males:
Liver can't degrade estrogen and 17-ketosteroids leading to increased androstendione.
Androstendione aromatized to estrogen in Adipose tissue:
1. Gynecomastia
2. Spider telangiectasia
3. Female distribution of hair