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Clinical signs of a Hepatobiliary disease
the rule is that a hepatobiliary dysfunction leads to a hepatobiliary clinical sign.
Combined all in WaBBBeNN
1- Water (Wa):
Polyuria PU/ Polydipsia which are multi-factorial:
psychogenic
hypercortisolism
renal concentrating defects.
2- Bilirubin (1st B): A cholestatic disease causes bilirubinuria and icterus that may appear also by a hemolytic disease. Then by severe cholestasis leads to acholic grey feces.
3- Blood (2nd B): Coagulopathy occurs due to the inability to synthesize clotting factors following severe hepatic failure or common obstruction. Subclinical clotting disorders may convert into clinical apparent ones just after hepatic biopsy, surgery or gastroduodenal ulcer.
4- Belly (Be): Ascites
Severe chronic hepatic disease causes hypoalbuminemia, portal hypertension, sodium and water retention.
Also rupture of bile duct leads to bile peritonitis as well as fluid accumulation.
5- Nervous (N): Hepatic encephalopathy occurs as a result of bacterial action on some substrate in colon that forms some potential encephalopatic toxins like ammonia, GABA and mercaptans ..etc, then by low detoxification of diseased liver or portosystemic shunt, metabolic encephalopathy rises leading to wax and wane nervous signs that may ended by coma.
6- Non-specific signs (the last N):
Vomiting and small bowel diarrhea which is less frequent than vomiting.
Hematmesis as a result of ulceration.
Anorexia and weight loss.
10.03.17
4/100 days of productivity // studying for my hematology exam on Friday
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Our article reporting on the outbreak of bleeding complications and coagulopathy from superwarfarin-laced synthetic cannabinoids (a.k.a. Spice or K2) in Illinois from earlier this year was published in The New England Journal of Medicine (@nejm) this week along with an Editorial! Shout-out to my outstanding co-authors Nichole Smith, Annia Martial, Harsha Vardhan Reddy, Michael Tarantino, and Jonathan Roberts. #publichealth #hematology #syntheticcannabinoids #superwarfarin #coagulopathy #k2 @amermedicalassn @ash_hematology @ufhealth @uflorida https://www.nejm.org/doi/full/10.1056/NEJMoa1807652?query=featured_home https://www.nejm.org/doi/full/10.1056/NEJMe1810418 (at University of Illinois College of Medicine at Peoria) https://www.instagram.com/p/BoNcyTuFf1W/?utm_source=ig_tumblr_share&igshid=emc573m0pq62
Murine model to study acute traumatic coagulopathy Acute traumatic coagulopathy (ATC) is an acute and endogenous mechanism triggered by the association of trauma and hemorrhage.