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Pathophysiologic relationship between cirrhosis and portal hypertension.

Case #1: A 64-year-old man presents to the emergency department (Links to an external site.) with abdominal pain and distention, as well as constipation of 8 days’ duration. He denies vomiting, fever, diarrhea, or dysuria. Except for hypertension, he is otherwise healthy with no prior surgeries.
His vital signs are normal except for a borderline pulse of 99 bpm. His physical examination is unremarkable except for his abdomen, which is large, rotund, and tympanitic. There is diffuse tenderness everywhere in the abdomen.

  1. What history would you want to obtain?
  2. What differential diagnoses would you consider?
  3. List and describe the specific diagnostic tests you might order to determine cause of his concern?
    Case #2:
    Kyle is a 58-year-old man who is experiencing lower abdominal discomfort nausea and diarrhea lasting 2 days. He thought he had eaten something that “disturbed his stomach” but since this has lasted so long, he is afraid it’s something serious.
  4. As you obtain a history from this patient what differential diagnoses are you considering. Give rational for your choices.
  5. Discuss the pathophysiologic relationship between nausea and vomiting?
    Three days after Kyle’s initial visit his labs confirmed a diagnosis of cirrhosis.
  6. Discuss the pathophysiologic relationship between cirrhosis and portal hypertension.
    Cite current research findings, national guidelines, and expert opinions and controversies found in the medical and nursing literature to support your position and suggestions.

Sample Solution

t book in the Harry Potter series, published in 1997, because it was immediately very popular and made Harry Potter and J. K. Rowling household names all over the world. The series has been translated into more than 75 languages. This shows that the book has attracted millions of readers. Fantasy is defined as a story that shows a world of fiction and imagination where scientific or scary elements are the main theme. Often the plot of the fantasy is magic and takes place in another world, not in our real world. Also, the plot may involve mythical creatures, witches, or talking animals that may wear clothes and live in houses. Some of the most famous fantasy fiction is Narnia and the Lord of the Rings. The reason I chose Harry Potter and the Philosopher’s Stone is that it was the first book in the series and the first work that J.K. Rowling ever published. It is full of fantasy elements and is very popular all around the world. It has many lessons that both adults and children can learn. About J.K. Rowling J.K. Rowling is the author of the Harry Potter series of fantasy novels. Rowling was born in London in 1965. She lived with her parents and her sister. Her family was not rich. She was a quiet child and she did not get her education in a special school. When she was on the train in 1990 traveling to London she got the great idea of a boy who was studying in a school for wizards. In December the same year her mother died of suffering from multiple sclerosis. At the same time she was writing the first novel of Harry Potter. She didn’t tell her mother about it. Her death affected Rowling’s writing because she wrote a lot of details about Harry’s own loss in the first book because she knew the feeling of loss so deeply. She married for the first time in 1992, and in 1993 she had her first child Jessica. But on 17 November she and her husband divorced. Rowling finished her manuscript in 19
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