Question: KS Is A 65 Year Old Caucasian Male. His Neighbor Brings Him To The ED Because He Has Not Been Out Of His Trailer In Several Weeks And His Neighbor Found Him In Bed And Difficult To Rouse. On Exam He Is Obtunded But When He Is Woken, His Hands Jerk. His Skin And Sclera Are Yellow-green. He Is Disheveled And Thin Except For His Abdomen Which Is Protuberant. …

KS is a 65 year old Caucasian male. His neighbor brings him tothe ED because he has not been out of his trailer in several weeksand his neighbor found him in bed and difficult to rouse. On examhe is obtunded but when he is woken, his hands jerk. His skin andsclera are yellow-green. He is disheveled and thin except for hisabdomen which is protuberant. The skin over his abdomen is markedwith a tangle of veins.

Vitals:

165/70

HR 105

Temp 100 F

O₂ Sat 94%

Weight 155 lb

Height 72 in

BMI 21

Labs:

AST 200 units/mL

ALT 330 units/mL

Alk Phos 75 units/mL

Serum Total Bilirubin 3 mg/dl

Serum Indirect Bilirubin 0.8 mg/dl

Serum Albumin 2.2 g/dl

Serum ammonia is elevated

anti-HCV antibodies are positive

1. Explain how each of KS’s symptoms likely correlate to a liverdisorder. What are the terms used to describe his skin color andskin patterns, LOC, hand movements and abdominal girth?
2. Describe what each of KS’s lab values tell you about hishepatic function.
3. What are the greatest risk factors for contracting hepatitis Cvirus?
4. What are options for treatment in this acute phase of hepaticencephalopathy and long term?