HUN4446 alcoholica liver diease

HUN4446 alcoholica liver diease - • • • • N/V •...

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Unformatted text preview: • • • • N/V • fever altered lab values • AST, ALT • bilirubin • alkaline phosphatase nutritional management • adequate/high kcal (~1.5 x BEE) • adequate/high protein (1 to 1.2 g/kg BW) • moderate fat: 30­35% kcals • fluid/electrolyte replacement as indicated • no alcohol • adequate vitamin/mineral intake • liquid diet/TF/PN? treatment • bed rest • antiviral agents: B,C,D • alpha interferon • lamivudine • ribavirin Alcoholic Liver Disease ➢ ➢ ➢ ➢ Alcoholism • chronic consumption • >80 g ethanol/d • six 1.5 oz shots of liquor • six 12 oz cans of beer • six 5 oz glasses of wine general: • spectrum of lier injury • alcoholic fatty lier • alcoholic hepatitis • cirrhosis • related to continued alcohol abuse • malnutrition: often concurrent potential nutritional consequences • Wernicke's encephalopathy: thiamin deficiency • Korsakoff's psychosis: progression of Wernicke's encephalopathy; poor memory for recent events • Peripheral neuropathy: Thiamin and B6 deficiencies • Pellagrous psychosis: niacin deficiency effects of alcohol of nutrient metabolism • protein: • impaired synthesis • increased catabolism • CHO/glucose: • decreased glucose uptake • • • • decreased glycogen synthesis decreased gluconeogenesis Vit A: • direct effect on retinol metabolism • impaired conversion to retinoic acid Vit D: interference with metabolism calcium: • inhibits absorption • increases PTH secretion thiamin: • decreased formation of TPP • reduced transketolase activity • • ...
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HUN4446 alcoholica liver diease - • • • • N/V •...

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