Booze Blues:
A Case Study on the Liver

Abstract: Peggy Fender is an intoxicated, 59 year old woman who is visiting the emergency department complaining of abdominal pain. She says the pain is in the upper right quadrant of her abdomen. The PA examines her and finds her emaciated, jaundiced, and many bruises covering her arms, legs, and face; her liver is hard and enlarged, along with her whole abdomen being ascitic (swollen and fluid-filled). Mrs. Fender isn't entirely coherent because she knows who she is and where she is, but she can't tell much about her illness. A blood test shows elevated blood transaminases (liver enzymes), high blood glucose, and prolonged prothrombin time (slowed clotting time). Based on her history and current findings, the PA diagnoses Mrs. Fender with alcoholic cirrhosis, which resulted from her inflammation of the liver from heavy, and consistent alcohol ingestion. If alcohol abuse continues, it leads to fat accumulation in the liver, along with fibrosis and severe liver disfunction.

Questions:
Besides the nurse's “bender” comment, and Mrs. Fender's social history, Tim suspects alcohol abuse based on many of his physical exam findings. Name at least three signs and/or symptoms that point to alcoholism, and briefly explain why each sign/symptom may occur.
- The hard and enlarged liver: Sometimes known as Hepatomegaly which is a disease that cause infection of your liver and disturb the blood flow, this causes your liver to become infiltrated with benign or malignant tumors. They add mass to the liver, thereby increasing its size. (healthline.com)
- The elevated blood transaminases: This can occur when alcohol has been over indulged in. (ncbi.nlm.nih.gov)
- Ascites:Ascites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs. It results from high