Internal medicine notes

Apr 16th, 2015
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DefinitionIs a chronic disease characterized byscaring and necrotic tissue replacedby fibrotic tissue . Resulting inhepatic insufficiency and portalhypertensionCausesChronic alcoholismBilharziasMal nutritionViral hepatitisToxic drugsChronic biliary obstructionPathophysiologyWhen normal liver cells replaced byfibrous cells ,normal liver structure andfunction altered resulting in portal hypertension , a cities ,esophageal varices andhepatic encephalopathyThe progress of liver cirrhosis is slowly ,for that reason P may come late withcomplication of liver cirrhosisClinical featureOnset slowly may take yearsEarly complain include fatigue , anorexia, edema, epistaxis , gums bleeding,jaundice and weight lossLater complains occurs due to chronicfailure of the liver and obstruction ofportal circulation which includeconstipation, esophageal varices , ascites ,splenomegaly, pancytopenia , lowalbumin, DLOC and bleedingDiagnostic testLFT , liver scanLiver biopsy to detect destruction andfibrosis of liver tissueAbd U\S ,Esophagoscopy to assess varicesParacentesis to examine ascitic fluidCBC and electrolyteMangementStop alcohol and toxic drugsCorrect nutritional status byvitamins, nutritional supplementshigh calorie and low proteinTreat ascities and fluid over loadby the following1-dialy weight and assess abd girth2- restrict sodium and water intake3-bed rest to aid d

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