#129 A 48 year-old dark skinned man of African descent

A 48 year-old dark skinned man of African descent - Anatomy and Physiology

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A 48 year-old dark skinned man of African descent presents to his GP with “pitting” oedema. There is no shortness of breath and physical examination shows: blood pressure of 135/85 mmHg, pulse rate of 72 beats per minute, temperature 36.8˚C, chest - no abnormal findings, abdomen - a firm palpable liver edge. When questioned further he reveals that he has been drinking alcohol on a daily basis for about 7-8 years, sometimes to excess. He is 182cm in height and weighs 80kgs. His skin colour appears normal, however his sclerae are yellowish. A “Mulitstix” urinalysis test shows high levels of bilirubin.
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Free Chegg Answer

Pitting edema is common when there is a problem in the functioning of the liver, kidney, and heart function.
On examination, the liver is firm which indicates abnormally obstructed, and some time distended gallbladder is palpable at the liver edge.
Client is having yellow coloration of the sclera which is due to liver obstructed and high bilirubin level due to the inability of the liver to absorb it.
History reveals patients is drinking alcohol about 7-8 days. In liver disease, the blood usually remains low but in this case, the blood pressure is high because obstructed liver slows down the blood flow and causing high blood pressure which is also known as portal hypertension.
So the patient is most likely to have alcoholic hepatitis according to symptoms.