A Primer on Detecting Cirrhosis and Caring for These Patients without Causing Harm

Table 1

Clues to the presence of cirrhosis.

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Risk factors for liver disease, especially obesity, alcohol use, and high-risk behavior for hepatitis C

Sleep/wake reversal

History of fluid retention, gastrointestinal hemorrhage, or unexplained episodic confusion

Stigmata of cirrhosis, including palmar erythema, vascular spiders, and abdominal wall collaterals

Firm liver and/or enlarged spleen

Jaundice, ascites, or asterixis

Platelet count <160,000 × 10(9)/L

Abnormal liver tests

Prolonged international normalized ratio (INR)

Evidence of cirrhosis and/or portal hypertension on imaging

Unusual sensitivity to coumadin

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