This document discusses cirrhosis, a chronic disease characterized by widespread fibrosis and nodule formation that occurs when the normal flow of blood, bile, and hepatic metabolites is altered by fibrosis. It notes that cirrhosis has several types and is caused by factors like alcoholic liver damage, chronic hepatitis C, and non-alcoholic steatohepatitis. The pathophysiology of cirrhosis involves injury to liver cells initiating an inflammatory response and the formation of fibrous scars. Diagnosis involves tests like ultrasound, CT scans, MRI, and endoscopy. Potential complications of advanced cirrhosis include bruising, bleeding, jaundice, itching, and liver cancer.

1. Basics of Scientific Research.
Spring 2020.
Student Name: VIBHA KHETADE

2. INTRODUCTION.
•Chronic disease.
•progressive disease characterized
by widespread fibrosis and nodule
formation.
•Occurs when the normal flow of
blood, bile and hepatic metabolites
is altered by fibrosis.

4. TYPES.
1. Alcoholic cirrhosis
2. Postnecrotic cirrhosis
3. Biliary cirrhosis
4. Cardiac cirrhosis

5. CIRHHOSIS:
PATHOPHYSIOLOGY.
 Primary event is injury to hepatocellular
elements.
 Initiates inflammatory response with cytokine
release->toxic substances.
 Destruction of hepatocytes, bile duct cells,
vascular endothelial cells.
 Repair through cellular proliferation and
regeneration.
 Formation of fibrous scar.

6. CAUSES.
 Alcoholic Liver
Damage: injure the
liver by blocking the
normal metabolism of
protein, fats, and
carbohydrates.
•Chronic Hepatitis C:
causes inflammation
and damage to the liver
that over several
decades can lead to
cirrhosis.

7. CAUSES.
Non-alcoholic
steatohepatitis (NASH): In
NASH, fat builds up in the
liver and eventually causes
scar tissue.
Primary Biliary Cirrhosis:
There is prominent alkaline
phosphatase elevation as
well as elevations in
cholesterol and bilirubin.

8. SIGNS AND SYMPTOMS.
 Spider angiomata or spider nevi: consisting of
a central arteriole surrounded by many
smaller vessels due to an increase in
estradiol.
 Palmar erythema: Exaggerations of normal
speckled mottling of the palm, due to altered
sex hormone metabolism.
 Gynecomastia: proliferation of glandular
tissue of male breasts extending
concentrically from the nipples due to
increased estradiol.
 Hypogonadism: Manifested as infertility, loss
of sexual drive and testicular atrophy due to
primary gonad injury or pituitary function.

9. DIAGNOSIS.
 Ultrasound.
 Abdominal CT and bile duct MRI.
 Endoscopy.
 Gastroscopy.
 MRI of biliary tract and pancreas.

10. DIAGNOSIS.
MRI. ULTRASOUND.

11. COMPLICATIONS
As the disease progresses, complications
may develop. In some people, these may
be the first signs of the disease:
 Bruising and bleeding.
 Jaundice.
 Itching (pruritus).
 Hepatic encephalopathy.
 Sensitivity to medication.
 Hepatocellular carcinoma (primary liver
cancer)