DR Medhat MRCP

سؤال امتحان classification) • Assessment of severity of liver cirrhosis (Child-Pugh
Score 1 2 3
Bilirubin (µmol/l) 50
Albumin (g/l) >35 28-35 9 = C
• Investigations : see child`s staging + U.S.+ ascetic tapping.
• Complications :
1) Coagulopathy (bleeding tendency) [↓ clotting factors synthesis + ↓ platelets+↓
vit K]
2) Encephalopathy [ NH3,aromatic chain aa, enteric bacteria pass unchanged
through the liver or bypass the liver to the brain].
3) Ascites (portal HTN + Hypoalbuminemia].
4) Spontaneous bacterial peritonitis [on top of ascitis]→ TTT : Cefotaxime
5) Hepatorenal syndrome.
6) Cachexia
7) Hepatocellular carcinoma.
• Management :
General measures :
1) Ascites : diuretics (spironolactone)
2) Portal HTN : non-selective BB (propranolol).
TTT of complications
سؤال
77