10 Questions
This patient's abnormal LFTs can be attributed to his known ______.
cirrhosis
The most likely diagnosis is ______ syndrome, but it must be remembered that this is a diagnosis of exclusion.
hepatorenal
An ultrasound should be performed to exclude the presence of urinary ______.
obstruction
Spontaneous bacterial peritonitis (SBP) is a frequent precipitant of ______ syndrome.
hepatorenal
Patients with cirrhosis develop decreased peripheral vascular resistance secondary to splanchnic ______.
vasodilation
What condition is indicated by the patient's elevated BUN and creatinine, and why is correlation with prior creatinine values needed?
Acute renal failure; correlation with prior creatinine values is needed to confirm the acute nature of the renal failure.
What diagnostic test should be performed to exclude the presence of urinary obstruction in this patient?
Ultrasound
What is the potential role of paracentesis in this patient, and what condition is it meant to diagnose?
Paracentesis is indicated to diagnose spontaneous bacterial peritonitis (SBP), which is a frequent precipitant of hepatorenal syndrome.
What is the significance of the patient's cell count being far below the 250 cells/mm³ needed for a diagnosis of SBP?
The low cell count rules out SBP as a cause of the patient's condition.
What would be an appropriate next step to confirm a diagnosis of hepatorenal syndrome in this patient, and what would a failure to respond indicate?
A volume challenge would be an appropriate next step to confirm a diagnosis of hepatorenal syndrome. A failure to respond would be consistent with hepatorenal syndrome.
Test your knowledge on the diagnosis and considerations for hepatorenal syndrome, a condition that requires exclusion of other diagnoses. Learn about the correlation of abnormal LFTs with acute renal failure, the role of elevated BUN and creatinine, and the need for prior creatinine values in diagnosis.
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