Portal Hypertension and Bleeding Varices Learning Objectives
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Questions and Answers

What is the primary mechanism of action of beta blockers in the management of portal hypertension?

  • Enhance renal blood flow
  • Increase arterial vasodilation
  • Decrease cardiac output and splanchnic blood flow (correct)
  • Promote sodium and water excretion
  • In portal hypertension, what effect does liver fibrosis due to cirrhosis have on blood flow in the portal vein?

  • Increases blood flow
  • No effect on blood flow
  • Decreases blood flow (correct)
  • Causes arterial vasodilation
  • How does splanchnic vasodilation contribute to the pathophysiology of portal hypertension?

  • Promotes sodium retention
  • Causes arterial vasoconstriction
  • Leads to increased portal blood flow (correct)
  • Reduces cardiac output
  • What is the typical pressure gradient indicative of portal hypertension compared to normal pressure gradient?

    <p>&gt;10 mmHg</p> Signup and view all the answers

    How do beta blockers affect the splanchnic system to reduce portal blood flow?

    <p>Promote splanchnic vasoconstriction</p> Signup and view all the answers

    Which of the following is NOT a complication associated with portal hypertension?

    <p>Gastric ulcers</p> Signup and view all the answers

    What is the primary prophylaxis treatment recommended for patients with varices at high risk for bleeding?

    <p>Nonselective ß-blockers</p> Signup and view all the answers

    In the treatment of bleeding varices, which drug is preferred due to its ability to slow or stop bleeding by various mechanisms?

    <p>Somatostatin</p> Signup and view all the answers

    What is the preferred endoscopic treatment for bleeding varices due to its lower complication rate compared to other procedures?

    <p>Endoscopic band ligation</p> Signup and view all the answers

    Which of the following drugs is used in combination with vasopressin in the treatment of bleeding varices to prevent splanchnic vasodilation?

    <p>Nitroglycerin</p> Signup and view all the answers

    What is the gold standard for diagnosing varices?

    <p>Endoscopy</p> Signup and view all the answers

    Which grade of varices is characterized by large diameter (>5mm)?

    <p>Grade 2</p> Signup and view all the answers

    What is the maximum duration for which vasopressin should be infused in the treatment of bleeding varices?

    <p>24 hours</p> Signup and view all the answers

    Which drug class is cautioned against due to its potential increase in the risk of hepatorenal syndrome in cirrhosis patients?

    <p>Beta blockers</p> Signup and view all the answers

    What is the primary screening method recommended for all cirrhotic patients to detect varices?

    <p>Esophagogastroduodenoscopy (EGD)</p> Signup and view all the answers

    Which drug is used for secondary prophylaxis in patients with varices and should be titrated based on patient-specific factors?

    <p>Isosorbide mononitrate</p> Signup and view all the answers

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