Budd-Chiari syndrome

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Flashcards

Budd-Chiari syndrome

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Questions

USMLE® Step 1 style questions USMLE

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A 54-year-old woman is brought to the emergency department by her partner due to altered mental status for the last 2 days. According to her husband, the patient has become increasingly lethargic, disoriented, and agitated. The patient has a history of chronic hepatitis C infection that was diagnosed 14 years ago. She refused all treatment at that time. Temperature is 37.0°C (98.6°F), pulse is 98/min, and blood pressure is 104/74 mmHg. On examination, the patient is lethargic and oriented only to self. When her hands are outstretched in front of her and extended at the wrist, they exhibit a flapping tremor. The abdomen is nontender and mildly distended; shifting dullness to percussion is present. There is no nuchal rigidity. Stool occult blood is positive. Laboratory testing reveals the following findings:



The patient is started on emergent therapy for her symptoms. Which of the following best explains the pathophysiology of this patient’s current condition?

External References

First Aid

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Abdominal pain

Budd-Chiari syndrome p. 399, 723

Ascites

Budd-Chiari syndrome p. 399, 723

Budd-Chiari syndrome p. 399

labs/findings p. 727

portal hypertension p. 396

presentation p. 723

Childbirth

Budd-Chiari syndrome and p. 399

Hepatocellular carcinomas p. 399

Budd-Chiari syndrome and p. 399

Hepatomegaly

Budd-Chiari syndrome p. 399, 723

Liver failure

Budd-Chiari syndrome and p. 399

Necrosis p. 205

Budd-Chiari syndrome p. 399

Polycythemia/vera p. 438

Budd-Chiari syndrome and p. 399

Varices

Budd-Chiari syndrome p. 399

Summary

Budd-Chiari syndrome is a condition in which the veins that carry blood from the liver are blocked, causing liver congestions. It typically presents with a classic triad of symptoms, that include abdominal pain, ascites, and liver enlargement. There are two types of Budd-Chiari syndrome: primary and secondary. Primary Budd-Chiari syndrome is due to the obstruction to the hepatic veins caused by a venous process like thrombosis or phlebitis. In secondary Budd-Chiari syndrome the obstruction comes from the compression or the invasion of the hepatic vein by a non-venous process, usually by a tumor nearby.

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