INSTRUCTIONS Management of patients with complications of cirrhosis
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Management of patients with complications of cirrhosis
General Purpose: To provide information on managing patients with complications of cirrhosis. Learning Objectives: After reading the preceding article and taking this test, you should be able to: 1. Describe the pathophysiology and diagnosis of cirrhosis and the staging of cirrhosis complications. 2. Discuss risk factors for complications of cirrhosis and treatment options.
- End-stage liver disease is characterized by a(n)
- increase in cardiac output.
- increase in arterial BP.
- decrease in heart rate>.
- increase in systemic vascular resistance.
- The splanchnic and peripheral vasodilation from end-stage liver disease results in
- decreased stimulation of the renin-angiotensin-aldosterone system.
- reduced secretion of antidiuretic hormone.
- diminished renal blood flow.
- increased sodium excretion.
- Lab results for patients with cirrhosis include
- decreased PMN count.
- prolonged INR.
- Which of the following is not a diagnostic criterion of decompensated cirrhosis?
- hepatic encephalopathy
- variceal bleeding
- When the SAAG is 1.1 g/dL or greater, ascites is likely related to
- nephrotic syndrome.
- peritoneal carcinomatosis.
- portal hypertension.
- Moderate ascites with abdominal distension is classified as
- stage 1.
- stage 2.
- stage 3.
- Treatment of ascites commonly involves
- spironolactone and furosemide.
- 1 to 1.5 g/day sodium restriction.
- spironolactone and amiloride.
- norfloxacin or trimethoprim-sulfamethoxazole.
- After placement of a TIPS, there is a chance of developing
- hepatic encephalopathy.
- variceal bleeding.
- The treatment of choice for SBP is
- The development of hepatic encephalopathy is most often attributed to a high level of
- Hepatic encephalopathy characterized by somnolence to semi-stupor is
- grade 1.
- grade 2.
- grade 3.
- grade 4.
- A safer and equally effective alternative to neomycin for treating hepatic encephalopathy is
- Malnourished patients with cirrhosis commonly are deficient in all of the following except
- The main treatment for esophageal varices includes
- beta blockers.
- Immediate treatment of variceal rupture includes
- liver transplantation.
- administration of blood products.
- large volume paracentesis.
- vigorous resuscitation with 0.9% sodium chloride.
- An event that may trigger type 1 HRS is
- nonsteroidal anti-inflammatory drug administration.
- large volume paracentesis with the administration of albumin.
- stage 1 ascites.
- administration of midodrine.
- Major criteria for the diagnosis of HRS in patients with cirrhosis include
- hypovolemic shock.
- recent treatment with nephrotoxic drugs.
- presence of parenchymal kidney disease.
- serum creatinine greater than 1.5 mg/dL.
- A risk factor for HCC is
- prolonged corticosteroid use.
- chronic hepatitis C.