1. CIRRHOSISPathophysiology&Complications

3. Normal liver functions Carbohydrate Metabolism Hypo- or hyperglycemia Fatty Acids Metabolism Lipid Transport Hyper- or hypolipidemia Proteins Metabolism Serum Albumin Vitamin K–Dependent Blood Coagulation Proteins Bilirubin Metabolism Bile Production Fat-Soluble Vitamins Detoxification Drugs and hormones Providing continual source of energy for entire body Regulation of storage and modulate availability of systemic nutrients Subject to hormonal modulation by endocrine organs (Pancreas, adrenal gland, and thyroid, neuronal regulation)

5. What is Cirrhosis?

6. Definition: Nodular formation Hepatic necrosis and degeneration combined with hepatic regeneration and fibrosis leading to Nodular formation Cirrhosis

9. What is patophysiology of Cirrhosis?

10. Causes (Etiology of chronic necrosis) +Host (Liver reaction) Lead to Cirrhosis & complications Cirrhosis

26. What is clinical manifestation of Cirrhosis?

27. Clinical manifestations: - No symptoms (routine examination) 40% - Impaired hepatocellular function (Liver failure) - Portal hypertension - Clinical manifestation of underlying disease Cirrhosis

28. How do you make diagnosis of cirrhosis?

29. Diagnostic approach: 1.Liver function tests (PT, Pr., Alb, Bili, PLT) 2.Liver damage tests (AST>ALT, Alk.Ph) 3.Liver ultrasound (nodularity, decrease in size, portal vein enlargment, prominent left lobe) 4.Etiological diagnostic tests 5.Liver biopsy 6.Surveillance tests (AFP, sonography, endoscopy, pracentesis, creatinine) Cirrhosis

35. What is natural history of Cirrhosis?

38. What is general clinical management of cirrhosis?

41. Clinical management: 1.Etiological treatment 2.Prophylactic treatment 3.Pre-transplantation care 4.Liver transplantation Cirrhosis

49. How do you screen for EVs?

55. Ascites

70. SBP

83. Encephalopathy

95. Hepatorenal syndrome