HUN4446 cirrhosis - portal HTN collateral circulation...

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reduced pyruvate decarboxylase niacin: used to metabolize alcohol  Zn, Mg, K: increased urinary losses Vit B6: increased degradation folate: impaired absorption altered transport increased excretion Alcoholic Hepatitis: inflammation of the liver due to alcohol abuse increased AST/ALT ratio with AST/ALT ratio>2.0 severe cases: decreased serum Albumin, prolonged PT nutritional management: 35-40 kcal/kg BW protein: 1.2 to 1.5 g/kg BW (unless contraindicated) adequate vitamin/mineral intake abstinence from alcohol  Cirrhosis: liver cells filled with fat or damaged by inflammation cells die dead cells replaced with fibrotic connective tissue and nodules; scar tissue Etiology chronic viral hepatitis (C,B) alcoholism: Laennec's cirrhosis certain medications biliary tract obstruction other Effects of scar tissue and fat deposits hepatic blood flow inhibited
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Unformatted text preview: portal HTN collateral circulation esophageal varices: balloon tamponade (balloon in esophagus), sclerotherapy (cauterize TIPS to stop bleeding) medications (isosorbide + madolol); TIPS decreased serum albumin decreased plasma oncotic pressure reduced renal blood flow altered aldosterone production/metabolism Na retention ascites: accumulation of water in abdominal caity splenomegaly hyperammonemia sources of blood ammonia dietary protein sloughed cells GI bleeding urea cellular metabolism laboratory/clinical findings increased serum enzymes increased serum ammonia hypoalbuminemia increased serum bilirubin low platelets; increased PT; easy bruising jaundice, itching ascites splenomegaly (enlarged spleen) wt loss; malnutrition (PCM)...
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HUN4446 cirrhosis - portal HTN collateral circulation...

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