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What does the clinical scenario and liver function tests indicate?

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Posted on Fri, 22 May 2015
Question: want a professional to answer my case study that i will upload.
doctor
Answered by Dr. Ram Choudhary (27 minutes later)
Brief Answer:
please briefly mention your problem

Detailed Answer:
Hi
Welcome to healthcare magic.
Please provide brief details of your problem.
I will try to solve it for you.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ram Choudhary (12 hours later)
hey doctor

i have uploaded a case study which has all of the information regarding the patient.
there are some questions that i would appreciate if you could answer them in regards to that case presented.

thank you
doctor
Answered by Dr. Ram Choudhary (20 hours later)
Hi
Welcome back.
The clinical scenario and liver function tests are suggestive of alcoholic liver disease.
1. features suggestive of liver disease are raised bilirubin and deranged liver enzymes.
2.He is pretty sick, he is having irrelevent talking, drowsy, having problems in mobility,
distended abdomen, swelling at legs all these factors are suggestive of hepatic encephalopathy and this condition portends a
probable poor outcome if the condition does not resolve soon. He should be evaluated
by a liver specialist and should be treated as indoor patient.
3.The current medicines need to be updated. Syp lactulose needs to be increased.
Spironolactone and lasix need to be stopped.
Human albumin to be given by IV.
4.He should be evaluated rapidly and should be shifted in the ICU as soon as possible
because early treatment makes an impact on the ultimate outcome.
5.His GCS and vitals monitoring should be done. Ultrasound of the abdomen should be done,
if needed upper GI endoscopy should also be done.
I hope the advise will be helpful for you.

Above answer was peer-reviewed by : Dr. Pradeep Vitta
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Follow up: Dr. Ram Choudhary (33 hours later)
can i have a more detailed answers for all questions?
e.g why monitor a certain thing and why remove a certain drug or increase dosage?


appreciate it
doctor
Answered by Dr. Ram Choudhary (3 days later)
Brief Answer:
some medicines need update

Detailed Answer:
Hi
Welcome back.
Alcoholic liver disease with encephalopathy indicates a very critical scenario. Such patients may have significantly swollen veins in the stomach and that may bleed badly and in unpredictable way.
Hence these patients should be managed in the ICU in consult with a gastroenterologist.
Daily hemoglobin and Alternate day LFT should be done apart from invasive hemodynamic monitoring.
Input of an intensivist would be valuable.
Some medicines need to be discontinued because they aggravate encephalopathy and lactulose helps in recovery so better be increased.
I hope that answers your query.
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Ram Choudhary

Internal Medicine Specialist

Practicing since :2001

Answered : 2270 Questions

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What does the clinical scenario and liver function tests indicate?

Brief Answer: please briefly mention your problem Detailed Answer: Hi Welcome to healthcare magic. Please provide brief details of your problem. I will try to solve it for you. Take care.