History & Physical A rather pale looking 32 yo female was seen in clinic today for complaints of decreased appetite, wea

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History & Physical
A rather pale looking 32 yo female was seen in clinic today for
complaints of decreased appetite, weakness, and general
malaise. She has a hx of Hepatitis C, initially diagnosed 3
years ago at which time she was treated with
alpha-interferon. She has been experiencing bruising which
does not appear to be related to injury. No ascites present,
but moderate swelling of hands and feet. Ht 68”, Wt 112#, she
reports losing 15# over the last couple of months. Labs (2/19) Na
129 low, Glucose 69 low, Bilirubin 3.8 high, Albumin 2.5 low,
Ammonia 35 normal, ALT 65 high, AST 199 high. A diagnosis of
Cirrhosis is confirmed with a liver biopsy and CT scan. A Low
Sodium, High Calorie diet has been ordered, and the Dietitian has
been consulted to evaluate.
Case Questions:
1. What may explain the recent bruising
she has been experiencing (hint: consider factors that affect
Prothrombin time)?
2. What are the current medical treatments
for cirrhosis? What is alpha-interferon, and would it be
helpful at this point?