Cirrhosis Assessment
- Degeneration and Destruction of Liver Cells
- Jaundice
- Fatigue
- Palmar Erythema
- Spider Angiomas
- Hepatosplenomegaly
- Edema
- Gynecomastia
- Change in LOC
Cirrhosis Interventions
- Maintain Nutrition
- Paracentesis
- Drug Therapy
- Endoscopic Band Ligation or Sclerotherapy
- Balloon Tamponade
- Transjugular Intrahepatic Portosystemic Shunt (TIPS)
- Lactulose
- Antibiotics
Complications of Cirrhosis
- Portal Hypertension
- Ascites
- Esophageal Varices
- Coagulation Defects
- Portal-Systemic Encephalopathy
- Hepatorenal Syndrome
Hepatitis A (HAV) Assessment
- Fecal-Oral
- Ingestion of Contaminated Food or Water
- 4 Weeks
- Fever
- General Malaise
- Hepatomegaly
- Self-Limiting
- Proper Hand Washing
Hepatitis B (HBV) Assessment
- Bodily Fluids
- Blood Transmission
- People Who Use IV Drugs
- Variable 1-6 Months
- Fever
- Nausea and Vomiting
- Hepatomegaly
- Cirrhosis
- Hepatocellular Carcinoma
- Vaccination
Hepatitis C (HCV) Assessment
- Blood Transmission
- High Risk Sex (rare)
- IV Drug Users
- 7 Weeks
- Cirrhosis
- Barrier Protection
Gilbert's Syndrome
- Decreased UDP-Glucuronosyltransferase Activity
- Decreased Bilirubin Conjugation
- Often Asymptomatic
- Jaundice (Mild)
- Fasting
- Stress
- Alcohol Intake
- Increased Unconjugated Bilirubin
Crigler-Najjar Syndrome Type 1
- Autosomal Recessive
- Absent UDP-glucuronosyltransferase
- Neonatal Jaundice
- Kernicterus
- Normal Liver Function Tests
- Elevated Unconjugated Bilirubin
- Phototherapy
- Plasmapheresis
- Calcium Phosphate and Orlistat
- Death often by Age 2
- No Response to Phenobarbital
Budd-Chiari Syndrome
- Pregnancy and Postpartum
- Hematologic Disorders
- Tumors
- Chronic Infections
- Thrombosis of Major Hepatic Veins
- Centrilobular Congestion and Necrosis
- Abdominal Pain
- Ascites
- Hepatomegaly
- Nutmeg Liver
Acute Cholangitis Characteristics and Clinical Features
- Biliary Tract Infection
- Biliary Tract Obstruction
- Charcot's Triad
- Fever
- Jaundice
- Abdominal Pain
- Reynold's Pentad
- + Hypotension
- + Altered Mental Status
Ascending Cholangitis Diagnosis and Treatment
- ERCP
- CT Scan
- Ultrasound
- Biliary Duct Dilation and/or Stones
- Hyperbilirubinemia
- Elevated Alkaline Phosphatase
- Elevated GGT
- Broad Spectrum Antibiotics
- Biliary Drainage
Hepatic Encephalopathy
- Seen in the Setting of Cirrhosis
- Hyperammonemia
- Altered Mental Status
- Coma
- TIPS
- Asterixis
- Lactulose
- Rifaximin
- Liver Transplant
Spontaneous Bacterial Peritonitis
- Cirrhosis
- Ascites
- Monomicrobial
- Often Asymptomatic
- Change in Mental Status
- Abdominal Pain
- Paracentesis
- PMN >250/mm3
- 3rd Generation Cephalosporin
- Albumin
- Antibiotic Prophylaxis