#101: Cirrhosis: Medications, decompensation, complications

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.8 • 3.1K Ratings

🗓️ 25 June 2018

⏱️ 40 minutes

🔗️ Recording | iTunes | RSS

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Summary

Cirrhosis. Take control of cirrhosis and treat your patients like the pros! In this episode of The Curbsiders, Dr. Scott Matherly, assistant professor in the Dept of Medicine at Virginia Commonwealth University and board certified hepatologist, builds upon his introduction to cirrhosis. You already know what to look out for and how to diagnose these patients, now it’s time to build your knowledge and medical repertoire against this deadly condition! Topics include: high protein diet, ascites, diuretics, hepatic encephalopathy, lactulose vs rifaximin, portal hypertension, esophageal varices, beta blockers, spontaneous bacterial peritonitis prophylaxis and more pathophysiology!

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Credits:

Written by: Cyrus Askin MD
Infographics: Beth Garbitelli
Produced by: Cyrus Askin MD and Matthew Watto MD
Hosts: Cyrus Askin MD, Matthew Watto MD, Stuart Brigham MD, Paul Williams MD
Guest: Scott Matherly MD

Time Stamps

00:00 Announcements
00:54 Disclaimer
01:30 Guest bio
02:28 NASH, diet, vitamin E, pioglitazone and prevention of cirrhosis
06:56 Clinical case of decompensated cirrhosis
09:02 Pathophysiology of circulatory dysfunction in cirrhosis and use of diuretics
18:25 Hepatic encephalopathy, ammonia, lactulose and rifaximin
25:10 Timing of medical therapy
26:39 MAP of 82 mmHg, beta blockers and variceal bleeding
31:04 Use of midodrine for hypotension
33:45 Prophylaxis of SBP
36:05 Take home points
38:04 Outro

Tags: cirrhosis, liver, high, protein, diet, sodium, restriction, ascites, diuretics, furosemide, spironolactone, hepatic, encephalopathy, lactulose, rifaximin, portal, hypertension, esophageal, varices, beta, blockers, spontaneous, bacterial, peritonitis, prophylaxis, pathophysiology, sbp, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist

Transcript

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0:00.0	This is Matt Wato and you are about to hear part two of our curbsiders episode on cirrhosis
0:06.7	with Dr. Scott Matherley.
0:08.6	In part one, we talked all about the diagnosis of cirrhosis in some of the predisposing conditions,
0:14.0	and also a little bit about the initial management.
0:16.8	On this next episode, we talked all about the medications that can be used to treat patients
0:20.7	with cirrhosis, some of the complications of cirrhosis, and a lot more really interesting
0:25.2	pathophysiology.
0:27.0	This episode was read and produced by Dr. Cyrus Askin with excellent infographics by Beth
0:32.3	Garbatelli.
0:34.2	I hope you enjoy it as much as you enjoyed part one.
0:37.7	If you haven't heard part one yet, then please go back and listen to that one first.
0:42.3	We are going to jump right into Dr. Matherley's bio and then right into the episode, none
0:46.5	of the normal intro banter.
0:48.5	So I know some of the audience will be happy about that.
0:52.0	All right, thank you and enjoy.
0:57.0	The first on your podcast is for entertainment, education, and information versus only
1:03.5	the topics discussed should not be used only by the industry, or by the industry, or by the
1:05.6	industry.
1:06.6	For the more the views, the same is expressed on the podcast, or solo the dose, and should
1:08.2	not be interpreted for the official policy for the version of AND, the cypheromphosphate,
1:10.2	the cash-like morons, or anti-filial outreach programs, if any, there are any, in fact,
1:12.2	there are none.
	...

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