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Management of Cirrhosis-Related Complications Overview4th Edition

Module Core Competency

Apply Evidence-Based Recommendations to Management of Cirrhosis-Related Complications in Persons with HCV Infection

Target Audience

Explore how to diagnosis and manage complications that may arise with chronic hepatitis C infection, including ascites, bacterial peritonitis, varicies, and hepatic encephalopathy. Also learn about referral for liver transplantation evaluation.

Editors

Jennifer Price, MD, PhD

Jennifer Price, MD, PhD
Professor of Medicine
Director, UCSF Viral Hepatitis Center
Division of GI and Hepatology
University of California, San Francisco

Disclosures:

Grants, Research support to Institution: Abbvie, Genentech, Vir Biotechnology, Zydus Pharmaceuticals

H. Nina Kim, MD, MSc

H. Nina Kim, MD, MSc
Associate Editor
Professor of Medicine
Division of Allergy & Infectious Diseases
University of Washington

Disclosures: None

1Lesson 1 Diagnosis and Management of Ascites

Learning Objectives
- Provide a list of causes in the differential diagnosis of ascites
- Diagnose ascites based on physical examination findings
- Describe the appropriate technique for performing abdominal paracentesis
- Summarize appropriate medical management and dietary recommendations for persons with ascites
- Discuss ascites-associated complications and treatment
Quick ReferenceDiagnosis and Management of Ascites Core Concepts

2Lesson 2 Recognition and Management of Spontaneous Bacterial Peritonitis

Learning Objectives
- Explain the diagnostic criteria for spontaneous bacterial peritonitis
- Differentiate spontaneous bacterial peritonitis from secondary bacterial peritonitis
- Select appropriate antimicrobial therapy for persons with spontaneous bacterial peritonitis
- List indications for initiating primary and secondary bacterial peritonitis prophylaxis
- Discuss appropriate regimens for primary and secondary bacterial peritonitis prophylaxis
Quick ReferenceRecognition and Management of Spontaneous Bacterial Peritonitis Core Concepts
Activity 2B.Role of Albumin in Treatment of SBP

3Lesson 3 Screening for Varices and Prevention of Bleeding

Learning Objectives
- Explain the basic pathogenesis of cirrhosis-related portal hypertension
- Describe how to diagnose clinically-significant portal hypertension
- Discuss the rationale and indications for variceal screening in persons with cirrhosis
- Summarize recommendations for prophylaxis of variceal bleeding
- List key aspects of managing acute variceal bleeding
Quick ReferenceScreening for Varices and Prevention of Bleeding Core Concepts
Activity 3B.Portal Hypertension and Approach to Gastric Varices

4Lesson 4 Diagnosis and Management of Hepatic Encephalopathy

Learning Objectives
- List the clinical features of persons with hepatic encephalopathy
- Describe specific diagnostic tests used to diagnose hepatic encephalopathy
- Summarize the approach to management of persons with hepatic encephalopathy
- Explain the rationale for using nonabsorbable disaccharides for the treatment of hepatic encephalopathy
- Discuss the role of antimicrobial therapy for the treatment of hepatic encephalopathy
Quick ReferenceDiagnosis and Management of Hepatic Encephalopathy Core Concepts

5Lesson 5 Referral for Liver Transplantation

Learning Objectives
- List the most common indications for cirrhosis-related liver transplantation
- Discuss the timing of referral for liver transplantation in the United States
- Use and interpret the Model for End-Stage Liver Disease (MELD) prognostic scoring system
- Describe the relative contraindications for liver transplantation
- Summarize the absolute contraindications for liver transplantation
Quick ReferenceReferral for Liver Transplantation Core Concepts

The Check-on-Learning Questions are short and topic related. They are meant to help you stay on track throughout each lesson and check your understanding of key concepts.

HCV Test and Cure

Screening and Diagnosis of Hepatitis C Infection

Evaluation, Staging, and Monitoring of Chronic Hepatitis C