7 Complications of Liver Dysfunction Free Online FlashCards

How does cirrhosis alter hemostasis?

Cirrhosis reduces both procoagulant and anticoagulant factors, creating a fragile rebalanced state in which bleeding and thrombosis are both possible.

Why can conjugated hyperbilirubinemia cause dark urine?

Conjugated bilirubin is water-soluble and can enter the urine, causing dark urine.

What causes should be assessed in acute kidney injury with cirrhosis?

Consider volume depletion, infection, medications, structural kidney injury, and hepatorenal syndrome; assess for alternative causes before diagnosing HRS.

When should hepatorenal syndrome be considered in cirrhosis?

Consider HRS when kidney dysfunction does not improve after appropriate assessment and management, and no stronger alternative explanation is found.

Does INR alone reliably predict bleeding risk in cirrhosis?

No. INR measures only part of the hemostatic system in cirrhosis and does not reliably predict procedural bleeding risk on its own.

Is routine coagulation correction recommended before low-risk paracentesis?

Routine correction of INR or platelet count before low-risk paracentesis is generally not recommended when there is no active bleeding.

Does cirrhosis protect against thrombosis?

No. Cirrhosis does not eliminate clotting risk; both bleeding and thrombosis can occur in its altered hemostatic state.

What do pale stools and a cholestatic enzyme pattern suggest?

Pale stools and a disproportionately elevated alkaline phosphatase suggest impaired bile flow; consider intrahepatic cholestasis or extrahepatic obstruction.

What is the priority with worsening jaundice, fever, and right-upper-quadrant pain?

Urgently assess for infection and biliary obstruction using laboratory evaluation and appropriate imaging.

Which medications may need to be withheld during acute kidney injury in cirrhosis?

Diuretics and nephrotoxic drugs such as NSAIDs may need to be withheld while precipitating factors and kidney injury are assessed.

What creatinine rise within 48 hours meets an HRS-AKI threshold?

A creatinine increase of at least 0.3 mg/dL within 48 hours meets one acute kidney injury threshold used in HRS-AKI criteria, but does not establish HRS by itself.

What other kidney injury criteria support considering HRS-AKI?

A rise of at least 50% from baseline within seven days is another acute kidney injury threshold; HRS-AKI also requires no improvement after adequate volume resuscitation when indicated and no strong alternative cause.