Question

Cirrhosis Case Study Mr. V. is a 55-year-old alcoholic who checked into a clinic, complaining he has been experiencing a persistent cough and has been feeling more fatigued, nauseous, and irritable. In addition, he is experiencing more frequent memory lapses. His abdomen is distended, but on palpation, his liver is small in size and firm, indicating cirrhosis. Lab tests indicate a decrease in hemoglobin, albumin, and prothrombin levels with elevated serum bilirubin and ammonia levels

. Case Study Questions

1. Differentiate the various stages that Mr. V.’s liver has progressed through and the implications of the current stage.

2. Examine specific rationale for each of Mr. V.’s manifestations and blood values.

3. Appraise whether it is possible to reverse the damage to the liver at this stage. What is Mr. V's prognosis?

4. Evaluate significant complications that are likely to occur, include a discussion on predisposing factors and effects on the liver.

Answer 1

From the history, clinical evaluation and laboratory study it is evident that patient suffering from liver cirrhosis. Stages of liver disease- stage of inflammation, stage of fibrosis stage of cirrhosis and end stage.
stage of inflammation- early stage. Liver get enlarged due to inflammation. No symptoms.
Stage of fibrosis – here inflamed liver starts to scarring. It is considered as compensated liver scarring. It can be treated. No complications.
Stage of cirrhosis – very much scarring occurs. Liver functions will become abnormal. Symptoms of liver disease starts to appear.
end stage liver disease (ESLD)- increased portal pressure and development of varices.
Portal hypertension is due to the increased portal venous inflow and increased resistance to the portal blood flow.
Varices develop due to dilatation of veins in lower esophagus and stomach as a result of increased pressure. development of ascites and other serious complications such and progressed to liver failure. Decompensated stage
Current stage of patient is ESLD- because patient having complications such as ascites(abdominal distention) memory problem(hepatic encephalopathy)anaemia, hypoprotenemia hyperammonenemia.
2. lab value
Decreased hb- due to folate deficiency and hemolysis. Hemolysis due to splenic enlargement
Low albumin and prothrombin is due to the decrease in synthesis due to diseased liver.(decreased production of coagulation factor)
Increased ammonia due to lack of conversion in to urea .
Increased bilirubin due to decreased clearance of bilirubin by liver
3. disease stage cannot be reverse.
Prognosis of the disease identified by Childs Turcotte Pugh score and MELD score both of them require more information.