What is the main cause of Laennec's cirrhosis?

Appeared in: DSSSB October 2024

Explanation

Laennec's cirrhosis is an older term for alcoholic cirrhosis, the most common type of cirrhosis in the Western world.
The primary and direct cause of this condition is chronic and excessive consumption of alcohol.
Alcohol is a hepatotoxin, meaning it is directly poisonous to liver cells. Its metabolism leads to fatty accumulation, inflammation (alcoholic hepatitis), and eventually, irreversible scarring (fibrosis) that defines cirrhosis.

Option A: Chronic hepatitis, particularly from viral infections like Hepatitis B and C, is a major cause of liver cirrhosis, but it leads to a type known as post-necrotic cirrhosis, not Laennec's.
Option B: Severe, long-standing right-sided heart failure causes a backup of blood into the liver, leading to chronic passive congestion and a condition known as cardiac cirrhosis.
Option C: Chronic obstruction of the bile ducts (e.g., from gallstones, tumors, or strictures) prevents bile from flowing out of the liver, causing inflammation and scarring known as biliary cirrhosis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Liver Cirrhosis as background academic context rather than a clinical decision trigger.
Nurses play a crucial role in screening patients for alcohol use disorder using tools like the CAGE or AUDIT questionnaires to identify at-risk individuals early.
Patient education is a key nursing intervention. For patients with Laennec's cirrhosis, the cornerstone of management is complete abstinence from alcohol to prevent further liver damage.
Nurses must monitor for life-threatening complications of cirrhosis, such as ascites, esophageal varices, and hepatic encephalopathy, and implement prescribed treatments promptly.

How to Approach the Question

First, identify the key term in the question: 'Laennec's cirrhosis'.
Recognize that 'Laennec's cirrhosis' is a specific medical term, often used interchangeably with other names. This is a factual recall question.
Access your knowledge base to recall the synonym for Laennec's cirrhosis, which is alcoholic cirrhosis or portal cirrhosis.
Once the connection to alcohol is made, evaluate the options. 'Excess alcohol consumption' directly matches the cause.
Briefly consider the other options to confirm they cause different types of cirrhosis (post-necrotic, cardiac, biliary), reinforcing the correctness of your chosen answer.

Concept Tested & Keywords

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E6 Pathology-Textbook of PATHOLOGYHarsh Mohan Part 3 (515-969) p. 111-113

E6 Medicine Harrison 22e Part 2 p. 612-614

Practise the full DSSSB October 2024

Attempt every question from this paper in a timed mock, then review the full solution for each one.