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ALCOHOLIC CIRRHOSIS :beer_mugs: (COMPLICATION :!: (Esophageal varices,…
ALCOHOLIC CIRRHOSIS
:beer_mugs:
DIAGNOSIS
:warning:
Physical examination
Chest finding
Skin finding
Abdominal finding
Extremity finding
Head and neck finding
Neurologic finding
Vital sign
Lab examination
:warning:
Complete blood count :warning:
WBC
Hb
Hct
Platelets
Prothrombin Time
Biochemistry :warning:
AST
ALT
Albumin
Total bilirubin
Na+
Cl-
K+
HCO3-
BUN
Creatinine
Stool occult blood :warning:
INTRODUCTION
TREATMENT
:check:
Luctulose for Hepatic encephalopathy
Lactulose appears to inhibit intestinal ammonia production by a number of mechanisms. The conversion of lactulose to lactic acid and acetic acid results in the acidification of the gut lumen
Vasopressin for Esophageal varices
Non selective vasoconstictor.
Intravenous injection.
stop blooding 70 %
Vasoconstriction of
Veins , Artery , Capillary and Smooth muscle of Esophagus.
Decrease
splanchnic blood flow and portal vein pressure.
Spironolactone + Furosemide for Ascites
Spironolactone is the drug of choice in the initial treatment It is an aldosterone antagonist, acting mainly on the distal tubules
Furosemide is generally used as an adjunct to spironolactone
Secondary prophylaxis
Beta 1-blockade
help blood flow less splanchnic into Portal system
Beta 2 -blockade
non-selective beta-blocker
( propranolol , nadalol , carvedilol )
COMPLICATION
:!:
Esophageal varices
Ascites
Hepatorenal syndrome
Hormonal disorders
Bleeding
Liver cancer
Spontaneous bacterial peritonitis (SBP)
PATHOLOGY
:recycle:
Pathophysiology
Jaundice
Hepatic encephalopathy
Caput medusa
Gynecomastia
Edema
Spider angiomata
Ascites
Pathogenesis
Liver cirrhosis
Metabolism of liver
1.alcohol dehydrogenase (ADH)
2.MEOS
3.catalase
4.aldehyde oxidase
Hepatic stellate cell
Anatomy of liver
ETIOLOGY
:explode:
Inherited disease
Nonalcoholic fatty liver
Autoimmune cirrhosis
Biliary cirrhosis
Hepatitis
Alcoholism
PREVENTION
:lock:
Eat a healthy diet and avoid to eat uncooked food.
Do not drink alcohol if you have cirrhosis.
Get a vaccine for hepatitis A,B , flu , pneumonia caused by certain bacteria and shingles.
SIGN AND SYMPTOM
:fire:
Spider nevi
Gynecomastia
Caput Medusa
Hapatic encepharopathy
Ascites and Edema
Jaundice
RISK FACTOR
:!?:
Alcoholism
Obesity
age
High iron in the body
Biliary cirrhosis
Post-hepatitis cirrhosis
sex
Epidermiolody