The Curbsiders Internal Medicine Podcast

#101: Cirrhosis: Medications, decompensation, complications

June 25, 2018
39 min

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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  • 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, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student

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