Etiology
Primary sclerosing cholangitis is associated with this GI disease
what is ulcerative colitis
this value indicates synthetic function of the liver and propensity to bleed
INR
this drug acts by reduction of intestinal pH, which favors the conversion of ammonia (NH3) the gut bacteria produces to ammonium (NH4+), an ionized form of the molecule that cannot cross biological membranes
lactulose
condition that occurs when pressure increases in the portal venous system, which is made up of the portal vein and the smaller veins that branch off from it
portal hypertension
this type of procedure should always be done in the ED when a patient with cirrhosis and ascites comes in with fevers and chills
diagnostic paracentesis
if you have this disease, you may need to do weekly phlebotomy to normalize serum iron levels, and then maintenance phlebotomy every 2–4 months
what is hematochromatosis
2° to hypersplenism, sequestration in the liver liver, and ↓ TPO production
what is thrombocytopenia
clinical sign indicating the inability to maintain a sustained posture of muscle contraction, resulting in brief, irregular lapses during a sustained posture
asterixis
This calculation is done to distinguish whether ascities is from portal hypertension vs not portal hypertension
What is SAAG > 1.1
The USPSTF recommends screening in adults aged 18 to 79 years
what is hepatitis C
Autoimmune disorder characterized by destruction of intrahepatic bile ducts. Most commonly presents in middle-aged women with other auto- immune conditions Laboratory findings include ↑ alkaline phosphatase, ↑ bilirubin, ⊕ antimitochondrial antibody, and ↑ cholesterol
what is primary biliary cholangitis
a person coming in with a variceal should be administered this medication that has been proven to confer a mortality benefit
what is iv ceftriaxone
a patient with HE is admitted and the team feels like despite efforts, the patient is unable to protect their away. what is needed next?
intubation
this procedure is needed when ascites is refractory to diuretics and the patient is particularly uncomfortable
what is a large volume paracentesis
this modality is used to screen esophageal varices
what is upper endoscopy
⊕ Antinuclear and anti–smooth muscle antibodies, elevated IgG
what is autoimmune hepatitis
these are the three criteria commonly cited for decompensated cirrhosis
EV bleeding, ascites, HE
oral antibiotic that can treat and prevent hepatic encephalopathy by reducing the amount of ammonia produced by gut bacteria and absorbed into the bloodstream
rifaxamin
this medication counteracts the hyper-RAAS activation. but it has an adverse effect potentially leading to cardiac arrhythmias
sprinolactone
this type of screening is done every 6 months with an ultrasound or mri
what is HCC screening
Kayser fleischer rings can be seen with this disease
What is Wilson's Disease
for acute/emergent bleeding events where upper endscopy cannot be performed safely, this procedure must be done
what is TIPS
diagnostic paracentesis reveals > 250 PMNs/mL
what is spontaneous bacterial peritonitis
ascites/fluid accumulation that enters the pleural space and impairs pulmonary mechanics
what is hepatic hydrothorax
what vaccines should you recommend to your patients with cirrhosis?
pneumococcal, hep a, hep b, flu