15 Cirrhosis

Cause and Stellate

  • find it on the sides of sinusoids in liver
  • produce fibrous tissues in cirrhosis

General Symptoms

  • liver convert ammonia to urea

  • palmar erythema: thenar and hypothenar redness (think estrogen makes skin red)

Portal HTN

  • hallmark in cirrhosis: vasodilation of splanchnic, low BP

  • must have portal HTN to develop ascites

  • portal HTN without cirrhosis
  • blood clot in portal vein

Ascites

SAAG

Peritonitis

Diagnosis

  • score includes bilirubin and INR (truly failing liver)
  • no AST/ALT: liver damage but not irreversible

Treatment

  • ammonia from amino acids and protein