Case presentation on

chronic liver disease


SHREYAS M SALIMATH
PHARM D 2ND YEAR
REG NO. 21Q0172
 DEFINITION

 Cirrhosis is when scar tissue replaces healthy liver
tissue. This stops the liver from working normally.
Cirrhosis is a long [ chronic ] liver disease. The most
common causes are hepatitis and other viruses, and
alcohol abuse. And other medical problems can also
cause it.
 EPIDEMIOLOGY

 The epidemiology of CLD, there are 257 million
people worldwide who are living with chronic HBV.
 Without proper management, approximately 20%
will die early of liver failure hepatocellular
carcinoma. It is estimated that only 11% of infected
persons are aware of their infection, and 17% of
those people receive treatment .
PATHOPHYSIOLOGY

 PATIENT PROFILE

PATIENT NAME : XYZ
AGE : 30
SEX : MALE
I.P NO. : 35791
DEPT : MEDICINE
DOA : 22/8/22
 REASON FOR
ADMISSION

 C/O Fever 3 days , C/O Burning micturaltion 8 days
 C/O Abdominal pain 8 days , C/O Increased
frequency of stool 8 days , Headache since 8 days
PAST MEDICAL
HISTORY


Not a * K/C/O , DM/HTN

HISTORY OF PATIENT
ILLNESS

 PT was apparently alright 8 days back then he
developed abdominal pain which was insidious in
onset progressive in nature then he developed
increased scd frequency of stool and headache. He
gives a high fever grade 3 days back he also C/O
Burning micturation no epistanis bleeding
hematuria a meleana . No cough , no chest pain , no
abdominal pain intension
 FAMILY HISTORY

 Appetite : Normal
 Sleep : adequate
 SOCIAL HISTORY

 Habits : alcohol consumption since 8yr back
drank 20 days back
 GENERAL PHYSICAL
EXAMINATION

 Pt is moderately built and norished consious and
oriented to TPP
 BP : 110/90 mmHg
 PT : 100 bpm
 SPO2 : 95% RA
 PROVISIONAL
DIAGNOSIS

 FEVER DECREASED EVALUATION
 INCREASED UTI , INCREASED CLD
 LABORATORY DATA

 HB : 10.8g/dl  RBS : 110.4
 WBC : 4700  SODIUM : 136mEq/L
 RBC : 3.20 million/ul  POTASSIUM : 3.7mEq/L
 PL : 2,02,000cells/mm3  CHLORIDES :
 ESR : 60 101mEq/L
 HIV : non reactive
 HBs Ag : negative
 DENGUE AND MP
ANTIGEN : negative
 
THYROID FUNCTION TEST
 RFT Sr.Urea : 17.7  Total protein test : 5.3
 Creatinine : 0.7mg/dl
 LFT :- ALT : 17.5 U/L
 Albumin : 2.0
AST : 31.2 U/L  Globulin : 3.3
ALP : 131.8 U/L  A/G Ratio : 1:1:6
BILIRUBIN
T : 0.3 MG%
D : 0.1 MG%
I : 0.2 MG%
 Radiology : urine R

 X-ray chest :

Pus cells: 1-2 / hpf

Epithelial cells : 0-1/hpf
 
 USG abdomen : impression – f/s/o chronic liver
parenchyma disease
 Suggested LFT carrelion
 Moderate ascites
 TREATMENT CHART
DAYS
BRAND GENERIC NAME
DOSE ROUTE FREQUENCY
NAME OF DRUG 1 2 3 4 5

IVF NS with Normal saline 100ml

IV 1-0-1
optineuron mv 1amp
inj Xone ceftriaxone 1gm IV 1-0-1 √ √
inj Pan pantoprazole 40mg IV 1-0-0 √ √
inj Emeset ondansetron 4mg IV SOS √

Tab Dolo paracetmol 650mg P/O 1-1-1 √ √

Cap vibactus Lacto bacillus P/O 1-0-1 √ √

Disodium
Syrp Cital 15ml P/O 1-1-1 √ √
hydrogen citrate
