emphasized

• Laennec's cirrhosis inhibits the removal of proteins and alters metabolism of vitamins and minerals
• biliary cirrhosis has retention of bile due to gallbladder involvement and gallstones seen
• pathophysiology of hepatitis

  • prodromal (preicteric) phase: about two weeks after initial exposure
  • flu like symptoms
  • highly transmissible
• pathophysiology of hepatitis

  • icteric phase: up to six weeks after exposure
  • symptomatic phase of illness (jaundice or other liver manifestations)
• pathophysiology of hepatitis

  • recovery (posticteric phase): when signs and symptoms are resolving, takes several more weeks and liver can remain enlarged even after this stage
• Manifestations of liver disease

  • pre-hepatic: excessive red blood cell destruction: (breakdown of hemoglobin bilirubin released into the plasma)
• Manifestations of liver disease

  • intrahepatic: liver is unable to remove bilirubin from the blood
• Manifestations of liver disease

  • Ascites "water belly"
  • pathophysiology
  • decreasing plasma protein levels: albumin
  • decreases reabsorption and promotes fluid shift into peritoneal cavity
• Manifestations of liver disease

  • Ascites "water belly"
  • increased RAAS
  • increased aldosterone (increase sodium)
  • increased ADH (increase water retention)
• Hepatomegaly will have RUQ tenderness
• gall bladder disease

  • cholelithiasis
  • obstruction
  • perforation a risk: large stone or increased number of stones increase this risk