Liver Cirrhosis, Hypertension, COPD, Hepatitis, Hemostasis: Causes & Symptoms

Posted on Dec 21, 2024 in Biology

Cirrhosis

Cirrhosis is a chronic disease characterized by nodules and fibrosis in the liver.

Phases:

  1. Ascites
  2. Hepatic encephalopathy
  3. Hemorrhage
  4. Jaundice

Glisson’s capsule covers the liver. The cells that defend the liver are Kupffer cells. Initially, there is hepatomegaly and then the size of the liver reduces.

Symptoms:

  • Vomiting
  • Anorexia
  • Abdominal pain (right upper quadrant) – Glisson’s capsule becomes inflamed

Signs:

  • Clubbing (fingers with enlarged tips)
  • Dupuytren’s contracture
  • Growth of the parotid gland
  • Peripheral neuropathy
  • Palmar erythema (redness in the palms of hands)

Classification of Cirrhosis:

  • Genetic
  • Chemical
  • Infectious
  • Alcoholic
  • Nutritional
  • Primary biliary
  • Secondary biliary
  • Cardiac failure
  • Indian childhood cirrhosis
  • Sarcoidosis

Hypertension

Blood pressure is the force with which blood pushes against the walls of blood vessels. It performs a potentially left ventricular (systolic contraction) of 120 mm/Hg. Diastolic pressure (relaxation-filled) is 80 mm/Hg.

Pressure is needed to maintain general circulation to all tissues. It also requires:

  1. A heart (pump)
  2. Blood vessels (pipes)
  3. Blood (water)

Hemodynamics (blood movement):

  • Cardiac
  • Fluid
  • Resistance

Higher blood pressure increases cardiac risk.

Pressure During the Day:

  • Morning and afternoon: high
  • During sleep: low

Normal activity: 130/85
Exercise: 145/90
Rest: 120/70

Hypertension, a cardiovascular disease, is diagnosed by elevated blood pressure above the figures regarded as normal. 20% of the world population has hypertension. It is a major reason for consultation and a cardiovascular risk factor. The higher the number, the greater the risk of mortality.

Classification:

  • Essential, primary, or idiopathic (92-94%)
  • Secondary
  • Nephrogenic

Normal: Systolic <135, Diastolic <88
Hypertension:
Mild: Systolic 140-159, Diastolic 90-99
Moderate: Systolic 160-179, Diastolic 100-109
Severe: Systolic 180-209, Diastolic 110-119
Very Severe: Systolic >210, Diastolic >120

Most patients are asymptomatic, but if any symptoms are present, they may include:

  • Occipital headache
  • Dizziness
  • Palpitations
  • Weakness
  • Blurred vision
  • Angina-type pain
  • Dyspnea

Diagnosis

Figures higher than normal on more than two occasions at the same time of day. Some patients get nervous when going to the doctor (white coat effect).

Treatment

Allopathic, homeopathy, diet, exercise. Diagnosis includes an electrocardiogram and a complete blood count (elevated erythrocytes). Remove salt, alcohol, fat, tobacco, chili, shrimp, rice, banana, and refined sugar from the diet. Eat fruits, vegetables, cooked chicken, milk, omega-3, apple, rice, and birdseed.

COPD (Chronic Obstructive Pulmonary Disease)

Normal respiratory rate: 14-24 breaths per minute
Children: 14-40 breaths per minute
Tachypnea: >24 breaths per minute
Bradypnea: <12 breaths per minute
Dyspnea: Difficulty breathing

Pathophysiological Features:

  • Hypersecretion of mucus (more common in bronchitis)
  • Ciliary transport disorder
  • Bronchial destruction
  • Inflammation of the bronchial mucosa
  • Destruction of bronchial walls

Pathophysiology

Inhalation causes the bronchial epithelium to receive macrophages, neutrophils, and lymphocytes. These create proteinases that cause destruction of the alveoli, hypersecretion of mucus, and bronchoconstriction.

Complications:

  • Heart: Pulmonary hypertension, right ventricular failure
  • Lung: Air trapping, impaired gas exchange, increased chest size

Emphysema

Emphysema involves airspace enlargement and tissue destruction. Signs and symptoms include:

  • Pink face
  • Broad chest (barrel-shaped)
  • Dyspnea
  • Weight loss

Bronchitis

Bronchitis involves obstruction of the small caliber airways with mucus. Signs and symptoms include:

  • Bluish discoloration of the skin (cyanosis)
  • Obesity
  • Dyspnea
  • Productive cough with large quantities of sputum

Risk Factors for COPD:

  • Smoking
  • Airway reactivity
  • Occupational exposure to dust
  • Pollution
  • Exposure to smoke
  • Lack of alpha-1 antitrypsin (in emphysema)

Diagnosis of COPD:

  • Complete medical history
  • Spirometry
  • Chest X-ray
  • Laboratory analysis

Treatment:

  • Stop smoking (gum, patch)
  • Oxygen mask
  • Antibiotics
  • Vitamin C, iron, and omega-3 in the diet
  • Protein and calories (in emphysema)
  • B complex vitamins
  • Large quantities of liquids

Hepatitis

Hepatitis is inflammation of the liver.

Causes:

  • Viral infections
  • Alcohol
  • Trauma
  • Drugs
  • Parasites
  • Bacteria

Risk Factors:

  • Unprotected sexual intercourse
  • Blood transfusions
  • Tattoos

Signs and Symptoms:

  • Jaundice
  • Choluria (dark urine)
  • Acholia (pale or white stools)
  • Hepatomegaly
  • Itching and dryness of the skin
  • Nausea and vomiting
  • Diarrhea
  • Weight loss
  • Fever
  • Abdominal pain

Hemostasis

Hemostasis is the arrest of blood flow. Arterial bleeding is characterized by a rapid pulse and bright red blood, while venous bleeding is characterized by a slow drip of dark red blood.

Steps of Hemostasis:

  1. Vasospasm
  2. Formation of a platelet plug
  3. Fibrin clot formation
  4. Clot retraction
  5. Dissolution of the clot

Coagulation Process:

  • Presence of platelets produced in the bone marrow
  • Von Willebrand factor (from the vascular endothelium)
  • Clotting factors that require vitamin K