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| * hepatic encephalopathy |
| | #531373 |
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what is the cause in cirrhosis-
increase in blood urea nitrogen
OR
increased absorption of nitrogenous substances from the gut
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| * Re:hepatic encephalopathy |
| #2188611 |
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This is what I've gathered about this this topic:
Normally liver is responsible to take extra nitrogen in the form of:
1. NH3 (a major toxic compound to CNS) from portal vein,
2. Alanine from muscle
and turn them into urea (urea cycle) and throw the urea into blood (= blood urea nitrogen BUN) so that kidney gets rid of it thru urine.
Now, if the liver is messed up, especially in case of cirrhosis, it cannot convert those toxins to urea (so BUN decreases, I guess), and NH3 and other toxic compounds in the portal vein pass thru liver without any intervention adn reach systemic circulation and cause encephalopathy.
Decreased absorption of nitrogenous substances from gut, if anything, would ameliorate, not cause, encephalopathy. This is actually the mechanism by which lactullose works which by intestinal bacteria turns into lactic acid and increased the pH in gut and so turns NH3 into NH4+ which is not absorbed by gut and will be excreted in feces.
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| * Re:hepatic encephalopathy |
| #2188618 |
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oh!!! nice, this thought never crossed me that since liver is defective, there will be less conversion of ammonia to urea and hence BUN would be decreased!!!!
i kept thinking for no reason that the BUN would be increased
hey thanks csfirst, u just made me learn/realise a new concept!!!!!
good luck!! |
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| * Re:hepatic encephalopathy |
| #2188625 |
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martin you're right... I always confuse between H+ and pH if I don't focus enough... you're welcome urapain:) I have the exam tmrw, wish me luck! |
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| * Re:hepatic encephalopathy |
| #2188671 |
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hey good luck!!! may you do exceedingly well!!! and may you get only questions you have read and know!!!!! ;)
please one request let us know how was it once you come back would be waiting for your valuable input!!!
good luck again
God bless |
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