Robert is a 68-year-old who has dealt with alcoholism for more than 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. (Learning Objectives 3, 4, 10, 11, 20)
1. Anemia and clotting disorders are common features of an alcoholic liver disease. Explain the various mechanisms that cause these hematologic disorders.
2. What gastrointestinal bleed is associated with a high mortality rate in those with advanced cirrhosis? Describe the pathophysiology of this condition.
3. Acute pancreatitis is sometimes seen in the alcoholic, particularly after binge drinking. Why are tachycardia and hypotension indications of this condition?
4. Women are more predisposed to alcoholic liver disease than men. Knowing what you do about the metabolism of alcohol, explain why this is so.
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