Ascites Management in Cirrhosis: Complications and Strategies

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15 Questions

What is the primary cause of ascites in cirrhosis patients?

Liver fibrosis

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

Activation of RAAS system

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

Stimulating sodium retention

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

Elevated aldosterone production

How does splanchnic vasodilation contribute to the development of ascites?

Resulting in arterial underfilling

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

Sodium and water retention

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

Splanchnic vasodilation

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?

Fluid accumulation due to portal hypertension

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

Abdominal ultrasound

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

<2g/day

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

Sodium restriction and diuretics

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

Hyperkalemia

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

If more than 5L of ascitic fluid is removed

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

NSAIDs

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

(TIPS) Transjugular Intrahepatic Portosystemic Shunt

Explore the pathophysiology, non-pharmacologic and pharmacologic management strategies, as well as primary and secondary prophylaxis for ascites in cirrhosis. Learn about complications such as portal hypertension, varices, spontaneous bacterial peritonitis, hepatic encephalopathy, and hepatorenal syndrome.

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