Mrs Fender Bender

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.

• Jaundice: The result of liver damage. The yellow color comes from the pigment found in bile, a digestive juice made by the liver. Bile is handled improperly and thus begins to circulate in the bloodstream, causing the skin color to change to yellow.

• Cirrhosis: A progressive chronic inflammation of the liver that typically results from severe chronic hepatitis or chronic alcoholism.

• Ascites: Abnormal accumulation of fluid within the peritoneal cavity; is excessive, causes visible

Lysosomes digest the toxins so they can be safely eliminated by the cell. Peroxisomes contain oxidases and catalases that detoxify substances like alcohol and neutralize free radicals. The smooth endoplasmic reticulum (ER) also contains enzymes that detoxify certain drugs (such as alcohol).

3. Mrs. Fender’s jaundice is caused by the accumulation of bilirubin in her blood and tissues. What is the normal fate of bilirubin, and what role does the liver play? Explain how Mrs. Fender’s cirrhosis is related to her jaundice.

• Bilirubin is a product of the heme of hemoglobin formed during the breakdown of erythrocytes. The liver removes the bilirubin from the blood and excretes it into the intestines as bile. When the liver is damaged, bilirubin, which is a yellow pigment, spills over into tissues and the blood, thus giving the skin a yellowish coloring. Jaundice is more apparent in the whites of the eyes.

4. Mrs. Fender’s prolonged clotting times and excessive bruising are related. Again, referring to normal physiological functioning of the liver, why do these two things happen when alcohol damages

The liver has a portal vein as well as a hepatic vein. It also has unique exchange blood vessels similar to capillaries, called “sinusoids.” How do these unique structures determine the function of the organ?

• The livers main function is to filter and process the blood it receives. The portal vein and hepatic vein then deliver the nutrient rich blood to the capillaries (sinusoids). The blood seeps in the sinusoids on its way to the hepatic veins, and then to the vena cava. This filtration is ideal for hepatocytes to filter the blood, process and store nutrients, cleanse, and remove debris.

6. Cirrhosis leads to scarring and increased hydrostatic pressure in the hepatic portal vein. Explain why this increased venous pressure causes net filtration to increase in the hepatic capillaries, leading to ascites (swollen and fluid-filled interstitial space of the abdomen).

• In alcoholic cirrhosis, the portal vein becomes scarred and blocked, causing an increase in hydrostatic pressure. Which leads to an increase in hydrostatic pressure in the capillaries. Alcoholic cirrhosis also causes the liver to under produce albumin. This lowers osmotic pressure in the vasculature, enhancing filtration out of the