• Card 31 / 34: A 55 year-old man with chronic hepatitis C related cirrhosis presents to the Liver Transplant Clinic for evaluation. He has had a large esophageal variceal bleed in the past and is now bothered by ascites. Which of the following best characterizes this patient’s circulation?
    1.) Low peripheral vascular resistance, low cardiac output, high rate of blood flow to splanchnic circulation
    2.) Low peripheral vascular resistance, high cardiac output, high rate of blood flow to the splanchnic circulation
    3.) Low peripheral vascular resistance, high cardiac output, low rate of blood flow to the splanchnic circulation
    4.) High peripheral vascular resistance, high cardiac output, high rate of blood flow to the splanchnic circulation
    5.) High peripheral vascular resistance, low cardiac output, high rate of blood flow to the splanchnic circulation

    Answer:
    2.) Low peripheral vascular resistance, high cardiac output, high rate of blood flow to the splanchnic circulation

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Explanation:

Cirrhotic patients have a hyperdynamic cardiac response to low peripheral vascular resistance. Portal hypertension (present given history of esophageal varices) develops due to resistance to blood flow in the liver and a high rate of blood flow in the splanchnic circulation.

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Gastrointestinal Pathophysiology Self-Assessment

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Attribution:  Laurence Scott Bailen, Tamsin Knox, Paul Abourjaily, Fredric D. Gordon,Marshall Kaplan,Andrew G. Plaut. PPY 222 Gastrointestinal Pathophysiology, Spring 2007. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/47 (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA
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