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Review Question - QID 215111

Cirrhosis and Portal Hypertension Introduction Pathogenesis QID: 215111 (M1.OMB.4752)
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QID 215111 (Type "215111" in App Search)
A 55-year-old man presents to the emergency department after an episode of emesis. He was eating dinner when he began vomiting up material of coffee-ground color and consistency. Over the past several months, he has also noticed some bilateral leg swelling and fatigue. He has a history of hypertension for which he takes hydrochlorothiazide. He is a nonsmoker and drinks 5-6 beers daily, which he has done for the past 20 years. The patient’s temperature is 97.8°F (36.6°C), blood pressure is 98/52 mmHg, pulse is 110/min, and respirations are 18/min. An abdominal exam reveals shifting dullness and a fluid wave. Laboratory findings are shown below:

Aspartate aminotransferase (AST, GOT): 84 U/L
Alanine aminotransferase (ALT, GPT): 40 U/L
Prothrombin time (PT): 25 seconds
Platelet count: 100,000/mm^3

What are the most likely changes (see Figure A) to plasma oncotic pressure, portal hydrostatic pressure, renin, and anti-diuretic hormone (ADH)?
  • A
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  • A