Cirrhosis complications, liver function test patterns, and pancreatitis mechanisms tested on USMLE Step 1, deeper than the general GI overview deck.
34 cards · basic cards · AI-written, checked twice. Edit anything.
- What causes esophageal varices in cirrhosis?
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Portal hypertension forces blood through portosystemic collaterals, including the left gastric vein into the esophageal venous plexus- What two factors drive ascites formation in cirrhosis?
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Portal hypertension (increased hydrostatic pressure) plus hypoalbuminemia (decreased oncotic pressure)- A serum-ascites albumin gradient (SAAG) of 1.1 g/dL or greater suggests what category of cause?
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Portal hypertension as the cause of the ascites- A SAAG less than 1.1 g/dL suggests what category of cause for ascites?
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A non-portal-hypertensive cause, such as peritoneal carcinomatosis or infection- What is the most common causative organism of spontaneous bacterial peritonitis (SBP)?
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Escherichia coli- What ascitic fluid PMN count is diagnostic of spontaneous bacterial peritonitis?
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Greater than or equal to 250 cells/mm3- What molecule is thought to accumulate and drive hepatic encephalopathy in cirrhosis?
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Ammonia, due to impaired hepatic clearance and portosystemic shunting- What is the first-line treatment for hepatic encephalopathy?
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Lactulose- What is the underlying mechanism of hepatorenal syndrome?
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Splanchnic vasodilation from portal hypertension leads to effective arterial underfilling and reflex renal vasoconstriction- What is the underlying mechanism of hepatopulmonary syndrome?
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Intrapulmonary vascular dilation causes ventilation-perfusion mismatch and shunting, leading to hypoxemia- What causes the caput medusae sign in cirrhosis?
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A recanalized paraumbilical vein shunts portal blood to the abdominal wall veins around the umbilicus- Portal hypertension can cause internal hemorrhoids by forming a shunt between which two venous systems?
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The superior rectal vein (portal) and the middle/inferior rectal veins (systemic)- Why does cirrhosis commonly cause gynecomastia in men?
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The damaged liver metabolizes estrogen less effectively, so estrogen levels rise relative to androgens- Why is PT/INR often the earliest lab marker to rise in acute liver synthetic dysfunction?
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Clotting factor VII has the shortest half-life of the liver-made coagulation factors, so its drop shows up quickly- An AST to ALT ratio greater than 2 to 1 is classically associated with what condition?
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Alcoholic liver disease
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