Source: Copstead, L. & Banasik, J. (2006). Pathophysiology (3rd ed.). Mosby. F.C. is a 54-year-old man with a history of chronic heavy alcohol use. He has frequent bouts of gastrointestinal bleeding for which he has been hospitalized on six separate occasions. He continues to drink and exhibits most of the common manifestations of alcoholic cirrhosis. He was recently hit by a car and was hospitalized for a broken leg. He appeared to be under the influence of alcohol at the time of the accident and had a blood alcohol level of 1.8. F.C.'s family reports that his mental functioning has deteriorated significantly over the past few months. Case Questions: 1. What are the common manifestations of alcoholic cirrhosis? Which of these are secondary to hepatocellular failure? Which are secondary to portal hypertension? 2. Why is F.C. at particular risk for GI bleeding? 3. What is the probable cause of F.C.'s progressive mental deterioration? How might his mental deterioration be medically managed? 4. What problems might be precipitated by F.C.'s abrupt cessation of alcohol intake while hospitalized?
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Jaundice and weight loss are secondary to hepatocellular failure, while ascites is secondary to portal hypertension. Show more…
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Case Study, Chapter 38, Disorders of Hepatobiliary and Exocrine Pancreas Function Robert is a 68-year-old who has dealt with alcoholism for over 30 years. He has cirrhosis and is anemic. His appetite has declined, and he regularly complains of abdominal pain. Recently, while preparing himself a sandwich, he cut his finger deeply with a knife. The wound bled profusely, and he used a kitchen towel to stop the flow. Refusing to go and seek medical assistance, he put ice on his finger and wrapped the towel around it. He sat down in his recliner with his hand over his head and fell asleep. 1. Anemia and clotting disorders are common features of alcoholic liver disease. What are the mechanisms that cause these hematologic disorders? 2. What gastrointestinal bleed is associated with a high mortality rate in those with advanced cirrhosis? What is the pathophysiology of this condition? 3. Acute pancreatitis is sometimes seen in the alcoholics, particularly after binge drinking. Why are tachycardia and hypotension indications of this condition? 4. Why are women more predisposed to alcoholic liver disease than men?
Keemin L.
Source: Copstead, L. & Banasik, J. (2006). Pathophysiology (3rd ed.). Mosby. M.B. is a generally healthy 36-year-old woman with complaints of persistent generalized fatigue. At her annual checkup, she is noted to have the following vital signs: heart rate 118 beats/min, blood pressure 128/60, oral temperature 37 degrees Celsius, respiratory rate 26 breaths/min. Her skin and nail beds are pale. Laboratory results demonstrate hematocrit (Hct) 31%; hemoglobin 10 g/dl; mean corpuscular hemoglobin concentration 27; mean corpuscular volume 70; total iron binding capacity 600 mg/dl. Case Questions: 1. What type of hematologic disorder would you suspect based on M.B.'s history, physical examination, and laboratory values? 2. What other history data would be helpful in determining the cause of this disorder? 3. Which of M.B.'s clinical signs are reflective of the body's effort to compensate for decreased oxygen carrying capacity? 4. M.B. is counseled to increase her dietary intake of iron-containing foods. What kinds of food would be recommended? 5. M.B. is given a prescription for ferrous sulfate 325 mg three times per day. What advice can you give to her about the timing of doses and expected side effects?
Madhur L.
Arterial stenosis is a constriction of an artery, often due to plaque buildup on the artery's inner walls. Serious medical conditions can result, depending on the affected artery. Stenosis of the carotid arteries that supply blood to the brain is a leading cause of stroke, while stenosis of the renal arteries can lead to kidney failure. Pulmonary artery stenosis results from birth defects, and can result in insufficient oxygen supply. Because the heart has to work harder to get blood through a constricted artery, stenosis can contribute to high blood pressure. In answering the questions below, assume steady flow (which is true in arteries only on short timescales). How does the volume flow rate of blood at a stenosis compare with the rate in the surrounding artery? a. lower b. the same c. higher
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