If bile obstruction occurs with cirrhosis, the patient will most likely develop \_\_\_\_\_. O hypertension O pruritus O diaphoresis O urinary retention
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Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and alcohol abuse. Show more…
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Chronic Liver Disease cannot be caused by the following ;Hypersensitivity to halothane anaesthesiaChronic persistent hepatitisPrimary biliary cirrhosisHepatitis A infectionAdministration of sodium valproatePlasma unconjugated bilirubin ;Is water insolubleGives a direct van der bergh reactionIs not bound to proteins in plasmaIs increased in haemolytic anaemiaIs readily transported across the blood-brain barrierPathological processes that may lead to increased urobilinogen in urine include ;Excessive haemolysisLiver damage due to anaemiaLiver damage due to chronic cirrhosisLiver damage due to toxinsBiliary obstruction due to cancer of the head of the pancreas
Jenny W.
A 59-year-old man develops fatigue and decreased appetite 3 months after receiving a mechanical aortic valve replacement. His pulse is 88/min, respirations are 12min, and blood pressure is 140/54 mm Hg. He appears tired. Physical examination shows mild scleral icterus. Jugular venous pressure is 8 cm H-0, and carotid upstrokes are normal. Lung fields are clear. Cardiac examination shows crisp prosthetic valve sounds and a grade 2/6, decrescendo diastolic murmur at the left sternal border. Abdominal examination shows no tenderness, normal liver size, and normal bowel sounds. Laboratory studies of serum show a total bilirubin concentration of 4 mg/dL and a direct bilirubin concentration of 1 mg/dL. Which of the following is the most likely cause of the jaundice in this patient? A) Cholelithiasis B) Cholestasis C) Hemolysis D) Hepatorellular disease E) Passive congestion
Asma V.
Title: Case Study 18: Cirrhosis Patient's chief complaint: Provided by wife: "My husband's very confused and he has been acting strangely. This morning, he couldn't answer my questions and seemed not to recognize me. I think that his stomach has been swelling up again, too. He stopped drinking four years ago, but his cirrhosis seems to be getting worse." HPI: S.G. is a 46-year-old white male with a history of chronic alcoholism and alcoholic cirrhosis. He was admitted to the hospital with abdominal swelling and confusion. He unintentionally gained 15 lbs during the last 4 weeks. He has not been sleeping well and has been lethargic, experiencing memory issues, and losing his temper uncharacteristically. PMH: Pneumonia 9 years ago, cirrhosis secondary to heavy alcohol use diagnosed 4 years ago with ultrasound and liver biopsy, history of uncontrolled ascites and peripheral edema, history of two upper GI hemorrhages from esophageal varices, history of anemia, history of E. coli-induced bacterial peritonitis 4 years ago, history of acute pancreatitis secondary to alcohol abuse. No history to suggest cardiac or gallbladder disease, and no previous diagnosis of viral or autoimmune hepatitis. SURG: Status post-appendectomy requiring blood transfusions 30 years ago, status post open reduction internal fixation of right femur secondary to motor vehicle accident 5 years ago. FH: Father died at age 52 from liver disease of unknown etiology, mother had rheumatoid arthritis and ulcerative colitis, died from a massive stroke at age 66, maternal aunt (age 71) with Graves disease. The patient has no siblings. SH: History of ethanol abuse, quit 5 years ago following a motor vehicle accident. Previously drank 3 cases of beer a week for 15 years. History of intravenous drug abuse (heroin) and intranasal cocaine, quit 5 years ago. Prior smoker (1/2 pack per day for many years). Meds: Propranolol 10 mg orally three times a day, Spironolactone 50 mg orally once a day, Furosemide 20 mg orally once a day, MVI 1 tablet orally once a day. Occasionally takes ibuprofen or acetaminophen for headaches. Patient has a history of non-compliance with medications. Allergies: No known drug allergies. ROS: Increasing abdominal girth. Patient Case Question 1: Hematemesis and tarry stools are clinical signs of which serious potential complication of cirrhosis?
Sri K.
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