LIVER CIRRHOSIS – PART I

Insult to liver on long run can cause fibrosis of the liver and formation of nodules ,which is termed as liver cirrhosis. Liver cirrhosis is a chronic condition of the liver in which there is fibrosis and formation of nodules. The normal architecture of the liver gets distorted and patient presents with number of clinical feature.

Causes of Liver cirrhosis include:
1. Infection: Hepatitis B, C, D
2. Toxins: Alcohol
3. Cholestasis
4. Vascular
5. Metabolic
6. Genetic
7. Cryptogenic

CHILD-TURCOTTE-PUGH CLASSIFICATION OF CIRRHOSIS SEVERITY

CHILD-TURCOTTE-PUGH CLASSIFICATION OF CIRRHOSIS SEVERITY

 

POINTS

  1 2 3
ENCEPHALOPATHY NONE GRADE 1-2 GRADE 3-4
ASCITIS NONE MILD-MODERATE SEVERE
BILIRUBIN (mg/dl) <2 2-3 >3
ALBUMIN (g/dl) > 3.5 2.8-3.5 <2.8
INR <1.7 1.7- 2.3 >2.3

 

CLASS A 5-6 POINTS (LEAST SEVERE)
CLASS B 7-9 POINTS   (MODERATE SEVERE)
CLASS C 10-15 POINTS (MOST SEVERE)

 

The rough diagram provided below will helps us memorizing all the major features of hepatic cirrhosis.
17887437_10154737177749585_120343564_o (1)
1. Hepatic encephalopathy
2. Jaundice
3. Epistaxis
4. Fetor hepaticus
5. Pigmentation
6. Purpura
7. Clubbing
8. Hepatomegaly
9. Splenomegaly
10. Ascites
11. Loss of libido
12. Impotence
13. Testis atrophy
14. Collateral vessels
15. Menstrual irregularities
16. Amenorrhea
17. Menorrhagia
18. Palmar erythema
19. Gynaecomastia
20. Breast atrophy
21. Spider telangiectasia
22. Cyanosis
23. Hair loss
24. Fever

DIAGNOSIS AND MANAGEMENT: PART 2

 

Dr Bivek Singh

Academic coordinator (MBBS)

Author “A journey into the human body”

Author “Pharmacology Simplified”

Board of Directors (Medical Outreach Nepal, USA)

biveksingh@hotmail.com

www.facebook.com/drbiveksingh

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DRBIVEKSINGH

Dr. BIVEK SINGH biveksingh@hotmail.com biveksingh123@gmail.com Board of Directors 2015/2016-Current Medical Outreach Nepal is collaboration between physicians from the United States and Nepal.  Academic Coordinator for MBBS students 03/2016- Current  Vice Chairperson 05/2015- 2016: Nyanopan (Social Organization)  Working on the third international book, Anatomy and Physiology.  Acknowledged as one of the resource person for writing a WHO manual draft on Cervical Cancer Screening in Nepal, in collaboration with Ministry of Health, Nepal, 2015.  On September 4th 2015, conducted a seminar on Anatomy and Physiology  Worked as an organizing secretary for conducting a first 3 days international residential training on Trauma, Resuscitation and Mass Casualty Management with collaboration from University of Texas Health Science Center San Antonio Texas, USA. (from 21st September to 23rd September).  Chief Executive Officer 04/2014- 2016: Tarun Sabha Kathmandu, Nepal  Member of the Executive Board 01/2013- 2016: Prerana Nepal Kathmandu, Nepal  Completed writing two books on medical subjects. The first book, A Journey into the Human Body, has been reviewed and appreciated internationally (2010-2013) Registered in Nepal Medical Council. Certified Website designer (3 months) from Escol Informations Pvt. Ltd, India. During the earthquake disaster in Nepal (2015), I lead a group of medical students and doctors to twelve affected places focusing on health camps, health sanitation and epidemics prevention. During the swine flu epidemics in Jajarkot, Nepal (2015), I volunteered to reach the swine flu epidemic area. Fashion icon intern of the year, First batch, KIST Medical College (Institute of Medicine, Tribhuvan University). Number of news/interviews/books/papers published.

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