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Stages of inspection of the patient with a chronic diffusion disease of a liver

Consecutive stages of clinical inspection of the patient with a chronic diffusion disease of a liver  


Stages and results of inspection

The most frequent clinical syndromes observed at chronic hepatopathies

Complaints
General weakness, fast fatigue, decrease in working capacity; nausea, vomiting, feeling of dryness and bitterness in a mouth, loss of appetite, an unstable chair, a meteorism, weight loss;

Asthenic
Dispepsichesky

Stages and results of inspection

The most frequent clinical syndromes observed at chronic hepatopathies

pain — long or acute in right hypochondrium or in an anticardium, feeling of weight in an upper half of a stomach after food with irradiation (in a waist, a back) or without it;

Abdominalno
painful

psychoemotional instability, sleeplessness, headache, cardialgia;

Vegetodi-
stonicheskiya

joint pain, long or alternating, without them

Joint

deformations; fever of not clear genesis, long or periodic;

Feverish

bleeding from a nose and gums, hypodermic hemorrhages, menorrhagias; hematemesis, tar-like chair;

Hemorrhagic

dysmenorrhea or amenorrhea, infertility, impotence, hair loss;

Endocrine

skin itch, urine darkening, clarification the calla resistant or the alternating yellowness;

Icteric

liquid delay, increase in the sizes of a stomach, hypostases of legs;

Edematous and ascitic

decrease in memory, drowsiness, the disorientation periods in time and space, inadequate behavior

Encephalopathic

Anamnesis

 

OVG, especially treated corticosteroids, or jaundice of not clear etiology, contacts with sick OVG; hemotransfusion or its components; contacts with blood (health workers), big operative measures, frequent courses of injection or infusional therapy, an extensive tattoo, long stay in the closed collectives, chronic diseases of abdominal organs;
chronic infectious, system and myeloproliferative diseases, states after transplantation of kidneys and other bodies, courses of chemotherapy and radiation therapy; alcohol abuse, systematic drug intake, drug addiction, chaotic sex life, sexual perversions, low hygienic level; long contact with industrial poisons or insecticides, existence of chronic diseases of a liver at the immediate family

 

Objective, clinical and datas of laboratory
Change of skin and mucous membranes; focal or diffusion hyperpegmentation (melanoderma), traces having combed a grayish and pale shade, yellowness, teleangiectasias, xanthomas and ksantelazma, petechias and ecchymomas, a hemorrhagic vasculitis; an erythema of palmar and manual eminences, stretching strips, cyanosis, a thickening of trailer phalanxes of fingers, a gynecomastia, a hypertrophy of parotid sialadens, a palmar fibromatosis, an atrophy of testicles, "crimson" language with smoothed nipples, expansion of saphenas of a front wall of a stomach, umbilical hernia, an atrophy of muscles of a shoulder girdle, a lymphadenopathy; hypostases of legs; increase in the sizes of a stomach;

 

Stages and results of inspection

The most frequent clinical syndromes observed at chronic hepatopathies

morbidity in the field of the right hypochondrium; hepatomegalia or reduction of the sizes of a liver; splenomegaly; vascular noise in an upper half of a stomach; right-hand hydrothorax, tachycardia, cyanosis, asthma, increase in amplitude of arterial pressure (hyper dynamic syndrome);
increase SOE or anemia of not clear genesis; thrombocytopenia, bent to a leukopenia; urobilinuria, bilirubinurea (high-quality reactions)
Initial biochemical screening
The general and conjugated bilirubin, ASAT, ALAT, ShchF and (or) GTP, crude protein and protein fractions of blood, a thymol turbidity test
Profound inspection
At identification of objective symptoms of a chronic disease of a liver at the previous stages

 

 
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