Chronic Alcoholism (started drinking half gallon of tuba every day at the age of 16, beer and redhorse 2-3 times a week) Chronic Alcoholism (started drinking half gallon of tuba every day at the age of 16, beer and redhorse 2-3 times a week) Liver Cirrhosis Liver Cirrhosis Risk Factors * Chronic alcoholism * Smoking * Diet Malnutrition Risk Factors * Chronic alcoholism * Smoking * Diet Malnutrition Predisposing Factors * Age > 45 y/o * Gender (more common in male) * Asian Predisposing Factors * Age > 45 y/o * Gender (more common in male) * Asian Chronic inflammation due to Helicobacter pyloriChronic inflammation due to Helicobacter pylori Adaptive increase in enzymes Adaptive increase in enzymes Liver cells became inflamed Liver cells became inflamed Inflammation of the lining of the stomach (gastritis) Inflammation of the lining of the stomach (gastritis) Contributing factors for hiatal hernia * Farmer (heavy lifting or bending) * smoking Contributing factors for hiatal hernia * Farmer (heavy lifting or bending) * smoking Ampicillin Causes chronic active gastritis Defect in gastrin regulation Increased acid H. pylori responses to increased gastrin Contributes to erosion of mucosa Ulcer formationGastric ulcer Gastrointestinal bleeding Causes chronic active gastritis Defect in gastrin regulation Increased acid H. pylori responses to increased gastrin Contributes to erosion of mucosa Ulcer formation Gastric ulcer Gastrointestinal bleeding Increased production of lipoproteins Increased production of lipoproteins Increased pressure on the abdomen Increased pressure on the abdomen Necrosis of hepatocyte Necrosis of hepatocyte Nausea, vomiting, Pernicious anemia Nausea, vomiting, Pernicious anemia Hyperlipidemia Hyperlipidemia Protrusion of the upper part of the stomach Protrusion of the upper part of the stomachAorta is atherosclerotic Aorta is atherosclerotic Hiatal hernia (2012) Hiatal hernia (2012) Liver fibrosis and scarring Liver fibrosis and scarring Bleeding Bleeding Hematemesis Hematemesis Melena Melena Abdominal pain Pain scale of 8/10 Abdominal pain Pain scale of 8/10 Portal Obstruction Portal Obstruction Dangerous hemorrhage Dangerous hemorrhage Vessel may rupture Vessel may rupture Esophageal varices Esophageal varices Varicose will form Varicose will form Veins will be distended Veins will be distended Venus collateral shunt (esophagus) Venus collateral shunt (esophagus) Portal hypertension Portal hypertensionBile goes to the bloodstream Bile goes to the bloodstream Bile backflow from GI to the liver Bile backflow from GI to the liver Causing yellowing of the skin and the eye (present) Causing yellowing of the skin and the eye (present) Development of pressure gradient (12mmhg) Development of pressure gradient (12mmhg) Liver fibrosis and scarring Liver fibrosis and scarring Infiltration of fibroblast Infiltration of fibroblast Decrease liver function Decrease liver function Deficiency inVitamin A,D,E,K Deficiency inVitamin A,D,E,K Decrease absorption of fat-soluble vitamins Decrease absorption of fat-soluble vitaminsMalabsorption of fats Malabsorption of fats Body malaise (jan. 21 2013) Body malaise (jan. 21 2013) Decrease glucose Decrease glucose Decrease energy Decrease energy Decreased metabolism of carbohydrates Decreased metabolism of carbohydrates Jaundice & Tea colored urine Jaundice & Tea colored urine Hyperbilirubinemia Hyperbilirubinemia Increased Urobilinogen ( High 418.
1 umol/l) Increased Urobilinogen ( High 418. 1 umol/l) Build up of conjugulated bilirubin in the blood Build up of conjugulated bilirubin in the blood Decreased Bilirubin metabolization and excretion Decreased Bilirubin metabolization and excretionBleeding tendencies Bleeding tendencies Decrease Vit. K absorption Decrease Vit. K absorption Edema Edema Ascites Ascites Tendency to reduction in effective systemic plasma volume Tendency to reduction in effective systemic plasma volume Increased accumulation of fluid in peritoneal cavity Increased accumulation of fluid in peritoneal cavity Increased hydrostatic pressure Increased hydrostatic pressure Reduced blood osmotic pressure Reduced blood osmotic pressure Hypoalbuminemia Hypoalbuminemia Reduced plasma albumin synthesis Reduced plasma albumin synthesis Decreased liver function Decreased liver function
