Progressive Care Nursing Certification (PCCN) Practice Exam

What is the primary cause of esophageal varices in patients diagnosed with cirrhosis of the liver?

1. Esophageal ulceration

2. Portal hypertension

3. Gastric ulcerations

4. Venous malformations

The correct answer is: Portal hypertension

Esophageal varices primarily develop as a result of portal hypertension, which is a common complication of cirrhosis. In cirrhosis, the liver becomes scarred and fails to function properly, leading to increased pressure in the portal venous system. This increased pressure causes the veins in the esophagus to become dilated and engorged, forming varices. These varices can rupture easily, leading to significant and potentially life-threatening bleeding. Understanding the pathophysiology behind this process is crucial for recognizing the risks and managing patients with cirrhosis. The liver's impaired ability to regulate blood flow due to cirrhosis is the fundamental mechanism that initiates portal hypertension, causing the formation of esophageal varices. The other options, such as esophageal ulceration, gastric ulcerations, and venous malformations, do not directly lead to the development of esophageal varices in the context of cirrhosis and portal hypertension. These conditions might affect the esophagus or stomach in other ways, but they do not represent the primary underlying issue related to portal hypertension and the resultant risk of variceal formation.