An Occupational Hazard

Get Started. It's Free
or sign up with your email address
An Occupational Hazard by Mind Map: An Occupational Hazard

1. Third Session

1.1. Step (9): Review of Learning Objectives

1.2. Step (10): Management

1.2.1. Goals Reversing damage Preventing insults to the liver Identify medication injurious to the liver Managing abnormalities and complications of cirrhosis Liver Transplantation

1.2.2. Alcohol-induced cirrhosis Stop alcohol intake Target symptoms Alcohol abstinance

1.2.3. Hepatitis B Treat the infection to slow the progression Happens in early or compensated stage Steatosis Short period use interferon Side effects for 12 months Anti-viral drugs in Compensated For life When to initiate treatment Liver failure Uncompensated Depends on viral load Check HBeAg

1.2.4. Stress refer to psychiatrist

1.2.5. Complications Varecial bleeding Spontaneous bacterial peritoneitis

1.2.6. Assesing of liver cirrhosis PT Encephalopathy etc... Model for end stage liver disease Bilirubin INR Determining prognosis

1.2.7. Supply deficiencies Coagulation factors Vitamins Proteins

1.2.8. Spironolactone Superior to others in ascites Low sodium diet Shift to furosemide

1.2.9. Vaccination against... Hep A Unless the patient recovered from previous infection Influenza

1.3. Liver Transplant

1.3.1. Reciepent Cardiac problems Lung problems Not Hep C +ve

1.3.2. Donor Non-living donor Take only a part from the liver

1.3.3. Prognosis Personnel Donor Wellbeing HIV

1.4. Step (11): Feedback & Resources

2. Second Session

2.1. Step (6): Review of Learning Objectives

2.1.1. Anatomy Largest gland in the body Significant metabolic functions Located in RUQ Two lobes Separated by falciform ligament Boundaries Histology Functional unit

2.1.2. Hyperbilirubinemia Unconjugated Hemolysis Excess production Increase uptake by the liver Conjugated Hepatic Post-hepatic How to differentiate between them Intrahepatic cholestasis

2.1.3. Alcohol consumption Alcoholic hepatitis Up to 30% Fatty liver Up to 100# Investigation LFT US Bilirubin Hepatocellular carcinoma Different type of acololic beverage Spirits Duration Genetic predisposition Clinicopathoological effects Steatosis

2.2. Step (7): Gathering Information & Inquiry Plan

2.2.1. History

2.2.2. Physical Examination

2.2.3. Investigation

2.3. Step (8): Diagnostic Decision

2.3.1. Mechanism

2.3.2. Presentation

2.3.3. Supporting Data

3. First Session

3.1. Step (1): Identifying Difficult Words & Cues

3.1.1. Difficult Words

3.1.2. Cues 48 old male Married 3 Children Migrated to Australia in 1995 Works as GP Drinks alcohol excessively Difficulty passing the AMC exams Jaundiced 3 weeks Dark Urine 3 weeks Feeling fullness Has been off his food Drop in energy level for the past few months Swollen ankle

3.2. Step (2): Problem Formulation

3.2.1. 48 year old male complaining of jaundice, dark urine, fullness in his abdomen, swollen ankles, & recent change in appetite. He drinks alcohol excessively.

3.3. Step (3): Hypotheses Generation

3.3.1. Alcohol consumption Jaundice = hyperbnilirubinemia Increase concentration of bilirubin in blood Jaundice appears as clinical feature Hands Sclera If liver parenchyma affected It cannot metabolize bilirubin Depressant agent Taken to be relaxed Early change in alchoholism is

3.3.2. Dark urine defect in conjugation of bilirubin thus dark urine

3.3.3. Alcohol Fatty liver Alcoholic cirrhosis Inlfmmation Cirrhosis Manifestation Acute Chronic

3.3.4. Bilirubin Comes from hemolysis Pre-hepatic Hepatic Life span of RBC 120 days losses its elasticity

3.3.5. Stress Liver problem

3.4. Step (4): Hypotheses Organization

3.4.1. Pre-hapetic

3.4.2. Hepatic

3.4.3. Post-hepatic

3.5. Step (5): Learning Objectives

3.5.1. To describe bilirubin biosynthesis & metabolism

3.5.2. To list the differential diagnosis of jaundice

3.5.3. To recognize the effects of alcohol on the functions of the liver

3.5.4. To desrice the approach to a patient with jaundice