We have all had them
But imagine they woke you up every night
For many people with #cirrhosis, that's life!
A #livertwitter #tweetorial featuring:
1⃣Who
2⃣Why
3⃣What to do
#meded #medtwitter #MedStudentTwitter
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![](https://pbs.twimg.com/media/Ebnjx3cWkAEss-B.png)
1⃣Mainly @🌙,in the🦵, intense
2⃣Common: 1 in 3 people
3⃣Risk factors? anyone cramps! No diff in labs!
4⃣Turns quality of life into💩
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![](https://pbs.twimg.com/media/EbnlmeFWAAIlOKS.jpg)
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1⃣⬇️ATP in muscle of ppl w/cirrhosis
🤔ATP needed for myosin to detach from actin
2⃣cramping in cirrhosis associated with
⬇️plasma volume &
⬆️renin activity
🤔Nerve perfusion depends on volume
&⬇️vol also⬆️sympathetic nerve activity
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So let's treat them
Incomplete list:
1⃣⬆️plasma volume
👉Hypertonic IVF works 4 dialysis cramps(Fig1)
some ppl use🥒Juice
👉Albumin works for #cirrhosis cramps(Fig2)
(🥒Juice trial pending)
2⃣Quinine?(Fig3)
3⃣Taurine?(Fig4)
4⃣Baclofen?
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1⃣⬇️muscle excitability(Fig1)
2⃣creates a 'refractory period'
3⃣FDA says🚫use (⬆️risk of🩸disorders)
Taurine⁉️
1⃣May reduce Ca2+ influx 2 muscle(Fig2)
2⃣May work(Fig3)
3⃣ #RedBull 4 all?
Baclofen⁉️
1⃣⬆️GABA motorneuron signal
2⃣May work(Fig4)
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1⃣Common (33%)
2⃣Causes:
-⬇️muscle ATP
-⬇️plasma volume
(⬇️🩸flow2nerves, vasoconstriction)
3⃣Trashes quality of life
4⃣Treatable. But first u have to ask!
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Hope you enjoyed!
I also hope
⭐️we⬆️awareness of often overlooked symptoms
⭐️That we can seize this telehealth moment to focus on what matters most 2 patient, use our video visits 2 solicit & address symptoms
Fin