Assignment task:
The selected disease process is cirrhosis which is a liver disease that occurs when scar tissue replaces healthy tissue preventing the organ from working normally. An injured tissue is replaced by a scar, known as fibrosis which often takes months or years of ongoing injury. The underlying pathophysiological mechanism of cirrhosis is the development of scar tissue that leads to the replacement of normal liver parenchyma causing blockage of portal blood flow and disruption of normal liver function. When fibrosis reaches a point where distortion of the hepatic vasculature occurs, it is called cirrhosis (Jagdish et al., 2023). If the damage continues, panlobular cirrhosis may occur. The cellular mechanisms responsible for cirrhosis are similar irrespective of the type of initial insult and the injury site within the liver lobule. The clinical manifestation observed in Bayani's case that could be explained by the pathophysiological mechanisms of cirrhosis is foul-smelling urine. This is due to the liver's inability to filter waste products effectively leading to a build-up of ammonia in the blood causing a strong, ammonia-like odor in the urine.
The clinical manifestations of cirrhosis depend on the advancement of the disease. The common early signs and symptoms are fatigue, loss of appetite, nausea, weight loss, itchy skin, and upper abdominal pain (Wu et al., 2024). The later signs and symptoms related to portal hypertension and declining liver function are vomiting blood, disruption in the menstrual cycle, jaundice, gallstones, dark-colored pee or stool, edema, blood in the stool, low urine output, shortness of breath, ascites and digestive difficulties. In Bayani's case, the clinical manifestations that can partially support a diagnosis of cirrhosis are foul-smelling urine, abdominal pain which is caused by a buildup of fluid in the abdomen (ascites), and mild confusion which occurs when a damaged liver cannot properly filter toxins causing them to build up in the brain leading to cognitive changes.
The diagnostic tests that would be most appropriate for investigating a diagnosis of cirrhosis in Bayani's case are physical examination, blood tests, imaging tests, and liver biopsy. A physical examination focuses on checking the medical history of Bayani, and the signs and symptoms related to cirrhosis. The blood tests for the disease include CBC, liver tests, and viral infection tests. For instance, liver tests can measure liver products like enzymes, proteins, and bilirubin levels in the blood to confirm cirrhosis. Imaging tests include MRI, CT scan, and abdominal ultrasound that show detailed images of the size, shape, and texture of the liver to confirm cirrhosis (Wu et al., 2024). A liver biopsy is a small procedure that involves taking a sample of the liver for examination to diagnose cirrhosis. Type 2 diabetes is a condition that causes high blood sugar levels because the body does not produce adequate insulin. In Bayani's case, the clinical manifestations that can partially support the diagnosis of type 2 diabetes are mild confusion often known as brain fog, abdominal pain, frequent water drinking and urination, and foul-smelling urine due to the production of ketones excreted in the urine. Need Professional Help?
References:
Jagdish, R. K., Roy, A., Kumar, K., Premkumar, M., Sharma, M., Rao, P. N., Reddy, D. N., & Kulkarni, A. V. (2023). Pathophysiology and management of liver cirrhosis: From Portal hypertension to acute-on-chronic liver failure. Frontiers in Medicine, 10.
Wu, Z., Chen, L., Chen, J., & Chen, C. (2024). Management of liver cirrhosis and its complications. Liver Cirrhosis and Its Complications - Advances in Diagnosis and Management.