Signs and symptoms include, fever, weight loss.
Anorexia and abdominal pain.
Jaundice ascites and hepatosplenomegaly
Worst case scenario,
once the liver starts undergoing dysfunction,
Now, you lose the ability to properly
metabolize your ammonia, huh?
And where is this Ammonia headed to?
What do we call this?
What am I doing?
I like Youtube but I'm not waving at you,
I can't help it.
This is resting, flapping tremors.
This is a sign for
Hepatic Encephalopathy. What with this
that I just did.
Also, bladder gland enlargement may be associated.
The diagnosis here, you will be using
your transaminases to your advantage.
I'm going to give a little bit more information
so that you can get your question right as well.
What is a Keutlopneumonic that I've heard.
As you know, I'm not a huge pneumonic man.
I mean strategically,
sometimes it can be fun.
But much of this information
is so that you can really excel on your exam
is by understanding the material.
But you toast to alcohol.
AST 2:1 ratio.
So, you're reading the stem,
you're reading the case,
and you find your AST to be 300,
and you find your ALT to
be 150, do not waste time
clicking on a button. Going through
the milleu of all those labs
when you know that 300
and 150 are at a 2:1 ratio.
Most likely, your patient is suffering from
Next, what else may happen?
What does "itis" mean?
Anytime there is inflammation,
no doubt you have a fever.
and most likely would have some type
of Leukocytosis and increase on WBC count.
Don't focus upon that. That the one
thing it will give you
mabye they'll give yout the AST/ALT ratio.
Almost always will.
And once your liver starts being
Woudl you tell me what are the two
other functional tests
or two important liver function tests
that will assess the functionality of your liver.
Here is one of them, PT.
which is normally should be from 11 to 15 seconds.
It starts getting prolonged.
The liver is being damaged.
And what about the bilirubin?
What do I mean by mixed?
By that we mean,
if the enzyme is being damaged
in the liver,
what can hyperbilirubin anemia please?
unconjugated hyperbilirubin anemia.
What if the export mechanism is affected
with Alchoholic Hepatitis,
you don't have a problem with enzyme per se.
Then you would have,
conjugated or direct hyperbilirubin anemia.
Pay attention to your mixed picture
and what kind of damage is taking
place within your liver.
What is these Mallory bodies
that you want to know?
The Mallory body is an intermediate
set of keratin filament remember?
In basis sciences, we talked about in basics,
how you can accumulate certain things in
This is not triglyceride.
I told you, I am not going
to cover the biochemistry
There you accumulate triglycerides.
Here, specifically under Hepatitis,
caused by alcohol, you're going to find
And in our discussion, it is important
that you know the Mallory body,
and I even showed you a picture.
These are intermediate Cytokeratin
filaments. At least take the operative word
Cytokeratin, cytokeratin, cytokeratin.
We have neutrophilic infiltration with
a background of...
there could be a little bit of fibrosis taking
So you might have a
cirrhotic type of picture just a little bit in the background.
Remember, what does Cirrhosis mean to you?
Anytime that you have injury
to any organ,
of course, Fibrosis is going to be involved.
Except for the brain, right?
Except for the brain.
Continuing forward. Discriminate function.
Something called the Maddery score.
You want to keep this in mind.
More so for for step2 CK.
and what you are doing here is your
taking a look at the PT.
I'm not going to walk you thorugh this
too much but you do have formula there.
Plus your bilirubin.
At least know the term:
Maddery score for Alchoholic Hepatitis.
And because you expect
your PT to be prolonged,
and maybe bilirubin to be elevated,
understand the concept first, ok.
Then if you want to come back
and memorize the formula,
you do that later, not now.
Understand the concept first.
The concept is: Prolonged PT because of
and your bilirubin will be elevated.
If you find your score to be increased,
Used to determine the need for
is the clinical application of a
concept that you've learned
and or continue to learn.
Corticosteroids improve short term mortality,
And we have something called Pentoxyfylline
decreases incidence of a very
important topic that we'll cover later.
And I have specifically extracted HRS
which stands for Hepatorenal Syndrome.
as a separate topic.
Because students always
seem to get that confused
and you can't afford to do that.
Point is, here is the drug to decrease
the incidence of it.
Adequate nutrition is critical.
Remember, if the liver is damaged, my goodness!
You end up causing all kinds of issues
especially, glycemic control and company.
Abstinence is crucial.
Why, why, why?
If abstinence is not exercised very patiently,
there's every possibility
that he or she is going into
end-stage liver disease.
Easier said than done though, huh?