Question

Case 1-Liver Cirrhosis A fifty-seven year old man with a history of alcohol abuse presents with the following signs or symptoms prolonged prothrombin time (PT); ascites and peripheral edema; enlarged breast tissue; steatorrhea, and periods of mental confusion; jaundice. He is diagnosed with alcoholic cirrhosis of the liver. 1. Define PT and explain why it is prolonged in our patient. What is the relationship between this value and his likelihood of clotting or bleeding abnormally? 2. What is portal hypertension? How can liver failure lead to portal hypertension and what role might portal hypertension play in the fluid imbalances observed? 3. What is meant by steatorrhea? Define the role of the liver in fat digestion and absorption. Could liver dysfunction alter fat absorption? Defend your answer. 4. What are the serum liver function tests used to assess the liver status? What are the normal ranges for the patient? 5. Why does our patient suffer from periods of mental confusion? Might our patient benefit from a protein- restricted diet? Why or why not. 6. What is the connection between liver dysfunction and jaundice? Explain the difference between direct and indirect bilirubin, how these are measured and what each refers to 7. Discuss the implications for medication administration with a patient who has been diagnosed with liver cirrhosis.

Answer 1

Image 1 explain about PT and its relationship with clotting and bleeding

Image 2 explain portal hypertension

Image 3 explain steatorrhea and role of liver in fat digestion and absorption

Image 4 explain serum liver function test and its normal values

Image 5 explain mental confusion

Image 6 describe connection between liver dysfunction and jaundice

Image 7 explain medicines implemented to patient of liver cirrhosis

Ist

2nd

1) Prothrombin Time : It is a Blood Test that measwies How long it takes Blood ito clot. - Prothrombin Time test can be used to check for Bleeding problems. * Prolonged pt means that the clot you m too late mainly in liver disease. Relationship between prothrombin time to Bleeding and clotting is, How much time taken to form clot. If clot form too late , it shows the prothrombin Time is prolonged.

CI - Portal 27 Partal Hypertension o n - Is Increase in Blood pressure within a system ton of veins called portal venous system. - Uver Pailure Weads To Hypertension : JF liver cells Damaged Body can't repair them. Body caney Blood to Liver. Through Pootal rein Stress on portal vein. ot cause High Blood pressure known as you чера Portal • typertension

* Posetal Hypertension play vuole in Plecid Smbalance in postal Hypertension , abnormal extracellulase Pleiad Results in Accumulation of fluid Ascites, pleural effusion or edema. Shows las

3rd

) uver secreie Bile n 6 Steatorshea : Is Ise in fat excretion in stool. o → Role of liver in Fat Digestion & absorption a liver secrete Bile Helps to digest and absorb Body fat • liver absorb fat from intestine. >> Yes, 4 liver loses its ability to change fat into a form that can be eliminated, then liver itself become fatty liver.

4th

@ Serum lovere function: Test :- are the test ® i provide information about the state of patient's liver, - Normal LFT (liver function Test) value is - ALT +7 to 55 units per litre.

5th

6 Patient suffer from Mental confusion due to 6 several reasons such as History of mental ellness, stressful life situations, death of loved one, divorce, etc. bragutan - No, patient should take protein diet. Inowe Balanced diet protein is neccessary for proper development and make person mentally stable.

6th

© Liver dysfunction and jaundice. Has a common © connection that jaundice ies common among the patients who has liver dysfunctioning. - Direct Bilirubin I Indirect Bilirubin Conjugated bilirubin unconjugated bilirubin also called direct bilirubin. I called indirect bilirubin Becoz it reacts directly Becor it has to be with in reagent. solubilized first - Direct Bilirubin Indirect measured from measured from Blood Total - Direct Bilirubin.

7th

® © Implications for medicine administexation with patient of liver cirrhosis: ne * Medicines implemented to patient of liver cirrhosis are depend on cause. Medicines aues Diweetics, Antibioties, Ammonia reducey, Beta Blockeres , Anti-viral drugs. -Best medicine is Ursodiol.