Ascites Management in Cirrhosis: Complications and Strategies
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Questions and Answers

What is the primary cause of ascites in cirrhosis patients?

  • Renin release
  • Splanchnic vasodilation
  • Liver fibrosis (correct)
  • Angiotensin II activation

Which physiological process leads to arterial underfilling and subsequent sodium and water retention in ascites?

  • Adrenal aldosterone production
  • Hypotension
  • Renin release
  • Activation of RAAS system (correct)

In ascites patients, what is the role of Angiotensin II in fluid retention?

  • Inducing arterial underfilling
  • Stimulating sodium retention (correct)
  • Inhibiting sodium reabsorption
  • Promoting potassium excretion

What physiological change occurs in the kidney in response to hypotension in ascites?

<p>Elevated aldosterone production (D)</p> Signup and view all the answers

How does splanchnic vasodilation contribute to the development of ascites?

<p>Resulting in arterial underfilling (C)</p> Signup and view all the answers

What is the primary consequence of activation of the RAAS system in ascites patients?

<p>Sodium and water retention (B)</p> Signup and view all the answers

Which step in the pathophysiology of ascites involves NO and hypotension?

<p>Splanchnic vasodilation (B)</p> Signup and view all the answers

What does a SAAG value of ≥1.1 g/dL and Ascitic Protein <2.5 g/dL indicate in a patient with ascites due to portal hypertension?

<p>Fluid accumulation due to portal hypertension (D)</p> Signup and view all the answers

Which diagnostic test is commonly used to assess the cause of fluid accumulation in the abdomen in a patient with cirrhosis?

<p>Abdominal ultrasound (B)</p> Signup and view all the answers

What is the recommended daily intake of sodium for patients with ascites?

<p>&lt;2g/day (C)</p> Signup and view all the answers

In the treatment of Grade 1 ascites, which non-pharmacologic intervention may be effective?

<p>Sodium restriction and diuretics (C)</p> Signup and view all the answers

What adverse effect is commonly associated with spironolactone in patients with cirrhotic ascites?

<p>Hyperkalemia (D)</p> Signup and view all the answers

In which situation should IV albumin be administered after therapeutic paracentesis for Grade 3 ascites?

<p>If more than 5L of ascitic fluid is removed (A)</p> Signup and view all the answers

Which medication type should be discontinued in patients with ascites due to cirrhosis?

<p>NSAIDs (A)</p> Signup and view all the answers

What procedure may be considered for ascites not responsive to diuretics and sodium restriction?

<p>(TIPS) Transjugular Intrahepatic Portosystemic Shunt (A)</p> Signup and view all the answers

Flashcards

Liver Fibrosis in Ascites

The process of scarring and hardening of the liver, impairing its function and leading to fluid buildup in the abdomen.

RAAS Activation in Ascites

A complex hormonal system activated in response to low blood pressure, leading to sodium and water retention in the body.

Angiotensin II's Role in Ascites

A potent hormone in RAAS, it directly stimulates the kidneys to retain sodium, further increasing fluid buildup.

Aldosterone Production in Ascites

The kidneys, sensing low blood pressure, produce more aldosterone, a hormone that also promotes sodium retention.

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Splanchnic Vasodilation in Ascites

Dilation of blood vessels in the digestive system, reducing blood flow to the heart and causing low blood pressure.

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Sodium and Water Retention in Ascites

The primary consequence of RAAS activation in ascites, leading to fluid buildup in the abdomen.

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NO and Hypotension in Ascites

A process where the body produces a molecule called nitric oxide (NO), causing blood vessels in the digestive system to dilate, leading to low blood pressure.

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SAAG Value in Ascites

This indicates that the fluid accumulation in the abdomen is primarily due to increased pressure in the portal vein, a common complication of cirrhosis.

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Abdominal Ultrasound in Ascites

A non-invasive imaging technique used to visually assess the size, shape, and contents of the abdomen, helping to identify fluid accumulation.

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Sodium Restriction in Ascites

A low-sodium diet is crucial for managing ascites as it helps reduce fluid retention.

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Diuretic Therapy in Ascites

Diuretics, medications that promote urination, help remove excess fluid from the body in mild ascites.

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Hyperkalemia with Spironolactone

A common side effect of spironolactone, a diuretic used to treat ascites, requiring careful monitoring.

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Albumin After Paracentesis

A significant amount of ascitic fluid removed during paracentesis can cause a rapid decrease in blood volume, requiring albumin administration.

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Avoiding NSAIDs in Ascites

Certain types of pain relievers, like NSAIDs, can worsen fluid retention and should be avoided in patients with ascites.

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TIPS Procedure for Ascites

A procedure that creates a connection between a vein in the liver and a vein in the abdomen, diverting blood flow and reducing pressure in the portal vein, helping to manage ascites.

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Transjugular Intrahepatic Portosystemic Shunt (TIPS) for Ascites

This procedure involves inserting a shunt into the liver to reduce portal pressure and improve blood flow, a last resort for ascites not responding to other therapies.

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