Cheatography
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patho and complications associated with cirrhosis
preventative and treatment for ascites, portal HTN, varices, hepatic encephalopathy, SBP, and HRS
Causes and treatment for pancreatitis
This is a draft cheat sheet. It is a work in progress and is not finished yet.
What is Cirrhosis?Significant damage to the liver, resulting in healthy tissue being replaced with scar tissue | Direct Damage to Hepatocytes Results In: | Inflammatory response | | | Collagen and fibrotic tissue deposited within sinusoids, making blood flow difficult | | | Remodeling of hepatic lobules | Increased resistance within hepatic lobule: | Due to fibrotic scar tissue within the sinusoid and increased vasoconstriction | Splanchnic blood vessels dilate, resulting in increased blood volume | Hepatic Fibrosis |
Causes of CirrhosisAlcohol | Primary | Infections | Viral hepatitis | Disease states | Wilson's disease, cystic fibrosis, hemochromatosis, chronic biliary obstruction, autoimmune biliary cirrhosis, nonalcoholic steatohepatitis (NASH) | Medications | MTX, amiodarone, dronedarone, APA (high doses) |
Alcohol and infections account for ~80% of cirrhosis cases | | Pathophysiology of CirrhosisScar tissue and fibroids are laid down in the sinusoidal space, resulting in an increased pressure due to blocked blood flow. | Scar tissue and fibroids will infiltrate the hepatocytes, disrupting the tissue and architecture of the liver. | An imbalance exists between vasoconstrictors and vasodilators. Vasoconstrictors are working in the liver, which causes blood to back up into the intra-abdominal vessels and blood pooling into the intra-abdominal space. | Vasodilators work in the intra-abdominal vessels (splenic vasculature), which causes more blood to pool in the abdomen, but can't progress through the liver due to the vasoconstrictors. |
Outcome of CirrhosisLiver is unable to perform normal functions | Filtration | Not able to effectively remove toxins, pathogens, or debris from the blood | Production | Decreased production of albumin, clotting factors (which can result in bleeding complications), and bile (may lead to digestive issues) | Metabolism | Think CYP Enzymes | | | Impaired processing of drugs, hormones, and ammonia (the natural breakdown of protein taken from the GI tract) |
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