MN551 Disorders of Endocrine Control of Growth and Metabolism

MN551 Unit 7 Assignment Endocrine Disorders

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Case Study 5: Disorders of Endocrine Control of Growth and Metabolism

Case Study 1: Alcoholic Liver Disease

Alcoholic Liver Disease

Alcohol is a legal substance in the United States and around the world. If the person is of age, alcohol consumption is legal. Importunely alcohol can lead to alcoholism in susceptible individuals and can become deadly. This paper is going to go over a case study related to an alcoholic man who has been drinking for over 30 years. According to Grissa et al., (2020) prolonged excess drinking can develop fatty liver and alcohol related steatohepatitis, which eventually progresses to liver fibrosis and then cirrhosis. In the initial stages of liver disease, there are few noticeable symptoms, and progression to cirrhosis becomes irreversible.

The Case Study

Mr. Robert is a 68-year-old male, who has been an alcoholic for the last 30 years. In the case study, the patient has liver cirrhosis and is anemic. The patient has noticed, his appetite has decreased and he regularly complaints of abdominal pain. Recently, the patient was preparing himself a sandwich and cut his finger deeply with a knife. Robert’s wound bled profusely, and he wrapped the wound with a kitchen towel to stop the flow. The patient refused to go to the hospital, he put ice on his finger and wrapped a towel around it. He sat down in his recliner with his hand over his forehead and fell asleep.

Mechanics of Hematologic Disorders

The liver is the organ responsible of hemostasis within the body. It is the main site where synthesis of all coagulation factors occurs. Patients with liver disease such as cirrhosis, often develop anemia and inability to coagulate. When the liver is not able to work properly, fibrinogen and clotting factors are decreased increasing the incidence of bleeding (Norris, 2019). At the same time Clotting times become affected by the malabsorption of vitamin K. Liver impairment also affects fat metabolism and the phospholipid cell membrane of red blood cells and leads to hemolysis (Norris, 2019). As cirrhosis advance, the liver continues to fail leading to hepatomegaly and splenomegaly. The decreased in all formed elements of the blood will lead to the development of anemia, thrombocytopenia, and leukopenia (Norris, 2019).

Esophageal Varices

Esophageal varices represent a medical emergency because they can be deadly. In cirrhosis patients, Esophageal variceal bleeding is the leading cause of morbidity and mortality (Kumar et al., 2020). Liver disease increases portal hypertension, due to weakened vessels, varices develop (Norris, 2019). The collateral circulation between the portal vein and the coronary vein, creates expansion of the esophageal veins (Norris, 2019).

What is Acute Pancreatitis?

Pancreatitis is the inflammation of the pancreas. The pancreas is an important organ in which insulin, hormones and digestive enzymes are produced. Pancreatitis can be developed due to excessive alcohol consumption, gallstones, genetic disorders, autoimmune disorders, and idiopathic causes (Adejumo et al., 2019). According to Norris (2019) in acute pancreatitis, fluid moves into the retroperitoneal and abdominal cavity. The blood volume change can be significant, affecting the fluid volume available for circulation causing hypotension and compensatory tachycardia.

Why Women over men?

Why are women more predisposed to alcohol damaged than men? It is commonly believed that the main reason is that women are smaller than men and have less body water than men.

However, women are more susceptible to alcohol liver damage due to having less metabolizing dehydrogenase enzymes in the stomach. In males the ADH system is usually depressed due to the testosterone production in men. The production of acetaldehyde in women makes them more predisposed to alcohol damage more than men (Grissa et al., 2019).

References

Adejumo, A. C., Akanbi, O., Adejumo, K. L., & Bukong, T. N. (2019). Reduced Risk of Alcohol‐ Induced Pancreatitis with Cannabis Use. Alcoholism: Clinical & Experimental Research, 43(2), 277–286. https://doi.org/10.1111/acer.13929

Grissa, D., Nytoft Rasmussen, D., Krag, A., Brunak, S., & Juhl Jensen, L. (2020). (“Alcoholic liver disease: A registry view on comorbidities and disease …”) Alcoholic liver disease: A registry view on comorbidities and disease prediction. PLoS Computational Biology, 16(9), e1008244. https://doi.org/10.1371/journal.pcbi.1008244

Kumar, P., Singh, K., Joshi, A., Thakur, P., Mahto, S., Kumar, B., Pasricha, N., Patra, B., & Lamba, B. (2020). “Evaluation of non-invasive marker of esophageal varices in cirrhosis of liver.” (“(PDF) Evaluation of non-invasive marker of esophageal varices in

cirrhosis …”) Journal of Family Medicine & Primary Care, 9(2), 992–996. https://doi.org/10.4103/jfmpc.jfmpc_854_19

Norris, T. L. (2019). Pathophysiology Concepts of Altered Health States. Philadelphia, PA: Wotlers Kluwer.