Case Study #1 F.C. is a 54-year-old man with a history of chronic heavy alcohol use. He has frequent bouts of gastrointestinal bleeding for which he has been hospitalized on six separate occasions over the years. He continues to drink and exhibits most of the common manifestations of alcoholic cirrhosis. He was recently hit by a car and was hospitalized for a broken leg. He appeared to be under the influence of alcohol at the time of the accident and had a blood alcohol level of 0.18. F.C.’s family reports that his mental functioning has deteriorated significantly over the past few months. 1. What are the common manifestations of alcoholic cirrhosis? Which of these are secondary to hepatocellular failure? Which are secondary to portal hypertension?
Some of the more common manifestations or signs and symptoms of alcoholic cirrhosis are vomiting, fever, nausea, jaundice and portal hypertension all of which can damage the body over time. Jaundice is secondary to hepatocellular failure, with the decrease and destruction of these cells the bilirubin is unable to be processed correctly. Portal hypertension is mainly caused by cirrhosis in which the vomiting and nausea are secondary due to this. These symptoms are manifested due to the tightening of the portal vein leading to the liver thus causing an increase in overall pressure and vascular resistance being key factors in the manifestations. 2. Why is F.C. at particular risk for GI bleeding?
F.C is at particular risk due to the chronic alcohol use and intake has cause mental functionality to rapidly decrease over a short time span. This indicates the use of alcohol has begun to affect motor function due to the increase in vascular resistance and the lack of a strong blood flow which both are being caused by the portal hypertension. His previous history of frequent hospital trips shows that his condition is worsening and not healing therefore the vomiting and GI bleeding is going to continue to manifest and putting even further strain on the liver due to the high intake of alcohol consumption. 3. What is the probable cause of F.C.’s progressive mental deterioration? How might his mental deterioration be medically managed?
The most likely cause of F.C’s progressive mental deterioration is due to Hepatic Encephalopathy which is cause by the liver being unable to remove waste and detoxify harmful substances in a quick enough manner, for example the high amounts of alcohol consumed. These toxins are then circulated and filtered into the bloodstream and can make their way into the brain causing this deterioration or even worse death. His mental deterioration can be managed by controlling the internal GI bleeding, and as well as controlling the proper fluid to get the liver functioning properly to flush out all the toxins circulating within the body.

Works Cited
Copstead, L. C., & Banasik, J. L. Pathophysiology: 5th ed. St. Louis, MI: Saunders, an imprint of Elsevier Inc. 2013. Print.