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A 39 year old man has a previous history of hepatitis C infection. He has gained weight over the past 4 months and has shifting dullness in the abdomen on examination. Which is the likely process contributing to the development of ascites?
A. Lymphoedema
B. Increased sodium reabsorption in the distal tubules of the kidneys
C. An albumin of 23 g/l
D. Right sided cardiac failure
E. Portal hypertension
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eee .....but why not ccccccccc
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if it was 2.3---yess but not if it is 23 !!
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in liver cirrhois hte cause of ascitis is sodium and water retention from the kidney not the ortal hypertension
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albumin normal range: 3.5-5.5 g/dl or 35-55g/l
so, i choose C b/c albumin is decreased 23 g/l b/c liver is trying to make coagulant factor, liver will use aminoacids for this process instead of doing albumin.
decreased albumin= decreased oncotic pressure( high Ph) and promote filtration, a positive process=EDEMA
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I live cirrhosis, liver cant synthesize sufficient amount of Albumin and there is low oncotic pressure that contribute to ascites and obviously there is portal hypertention in cirrhotic patients and also transudative oedema may be present due to portal hypertension. Could you pls tell the correct answer?
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the correct answer is B
under fill theory , PHTN + LOW ALBUMIN ALL WILL LEAD TO reduce renal perfusion then with increase in sympathatic outflow will lead to Renin activation and secondary hyperaldosteronism
water and sodium retention = generlized edema including ascitis
