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A 47-Year-Old Women With Alcoholic Cirrhosis and SOB

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Submitted by allen 16 months, 2 days, 17 hours ago

A 47-year-old woman is admitted to the hospital secondary to increasing shortness of breath. The patient has a history of alcoholic cirrhosis (diagnosed by liver biopsy 3 months ago) with ascites. She states that her abdomen has increased in size and that her breathing has become increasingly difficult. She has had mild abdominal discomfort for the last week but denies fever, nausea, vomiting, hematemesis, melena, or mental status changes. She denies excess fluid or salt intake and has been compliant with her medications, which include Lasix and Aldactone. Her social history is significant for heavy alcohol intake for 15 years. She denies current drug or tobacco use. Question 1 You are the resident on the floor admitting the patient. The patient carries a diagnosis of cirrhosis; however, you realize it is important to review the relationship between alcohol and liver function before examining the patient. How does ethanol damage the liver?

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comment (1) | Category: Medicine | Add allen as a friend

#1 - By preity, 16 months, 2 days, 17 hours ago.

Alcohol exerts its damaging effects by several different cellular pathways. Ethanol has a direct effect on membrane fluidity, leading to loss of membrane regulatory control and cell swelling. Another pathway involves the production of excess acetaldehyde from the metabolism of alcohol. Acetaldehyde exerts toxic effects on the hepatocyte and is responsible for a more severe lesion. During alcohol metabolism NADPH is formed, leading to an elevated redox potential favoring accumulation of hepatic triglycerides.

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