| Symptoms
& History
Physical
Findings
Stop
& Think
Lab
and X-Ray
Differential
Diagnosis
The
Disease
Treatment
Conclusions
Quiz
& Evaluation |
|
Several
aspects of Mr. Weiser's combined diseases need monitoring and/or treatment
now.
-
Esophageal varices: He
could experience a fatal hemorrhage. Even slow bleeding will clearly aggravate
his developing hepatic encephalopathy. All we can do right now is monitor.
-
Gastritis: This is what
he's currently most symptomatic with, and it's likely adding blood to his
GI tract. The bugs surely like it, but his serum ammonia will rise. No
alcohol intake, antacids and H-2 blockers should help.
-
Acute alcoholic hepatitis:
No booze and vitamin K may be all we can do for the present.
-
Advanced cirrhosis: Not
much on this front. This condition is progressive and non-reversible.
There is not going to be any reconstruction of his liver.
-
Splenic hypertrophy:
Be one the look out for infections as a consequence of WBC sequestration.
Low platelet and bleeds.
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