Liver insult Alcoholic Ingestion, Viral hepatitis Exposure to toxins

Hepatocyte Increase wbc fatigue liver Inflammation Nausea vomiting

anorexia

damage

pain

fever

Alterations in blood and lymph flow

Liver necrosis LIVER FAILURE ascite s

Anemia Thrombocyt openia splenomegaly Portal leukopenia

edema
Delayed Wound

LIVER FIBROSIS AND SCARRING

Liver fibrosis

bleeding

hemorrhoids

Esophageal healing infection Abdominal

varices

Superficial

bleeding

varices

HPN

Decrease ADH

edema

Palmar Erythema

Spider angiomas

Loss of Body hair

Dec.androgen/ Estrogen p.

Plasm a CHON

Testicul ar atrophy

Gyneco mastia

Menstru al change s

Dec.met.of CHON And Carb./ Dec.Fat Hypoglycemia Edema Acites Vit.k absop. Clay colored stool Bleeding tendencies

bile

Bilirubin excretion In urine

Dark urine

jaundice Bilirubin metabolism hyperbilirubinemi a

Increase serum ammonia

Alterations In sleep Foul breath

Inability to Metabolize Liver failure ammonia

Hepatic encephalopath y

Confusion to Hepatic coma Respiratory Asterexis acidosis

DEATH