HUN4446 cirrhosis - • portal HTN • collateral...

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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...

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