| Symptoms
& History
Physical
Findings
Stop
& Think
Lab
and X-Ray
Differential
Diagnosis
The
Disease
Treatment
Conclusions
Quiz
& Evaluation |
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Mr.
Weiser has been in the hosptial over night and his condition is
unchanged.
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His confusion and odd behavior
is not likely due to an admitting blood alcohol of 96 mg%.
-
He may be exhibiting early manifestations
of hepatic encephalopathy.
A biopsy of his liver,
and knowing if he has acute alcoholic gastritis, would be most helpful.
-
A liver biopsy can be
a problem in someone with cirrhosis. Low levels of clotting proteins
and portal hypertension can team up to make a potentially dangerous
bleed. Still, we don't know his liver status, so maybe the risk is
worth it.
-
The more immediate problem
is his stomach, acute gastritis (possibly hemorrhagic) and the presence
of esophageal varices.
Here's his
liver biopsy.
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