October online exam
57/M 1)Reason for ascites: As per the history and examination: ? A)cirrhosis of the liver secondary to chronic daily alcohol consumption Hepatosplenomegaly suggestive of portal hypertension B) hypo albuminemia-serum albumin being 1.6 , suggesting chronic pathology, ?decreased synthesis by the liver, (accompanied by decreased synthesis of vit k dependant clotting factors) 2)Reasons for lymphedema: Secondary causes as per history and examination are 1)infection:filariasis, cellulitis 2)trauma 3) non obstructive causes of chronic venous insufficiency https://www.ncbi.nlm.nih.gov/books/NBK537239/ Reason for ulcerations and recurrent blebs Lymphedema-the stagnation of lymph obstructs the clearance of bacteria Leading to constant cytokines and other inflammatory mediators release https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2804019/ 3)asterexis and constructional apraxia The cause for asterixis is the increased passage of ammonia across the blood brain barrier , absorbed mor...