Management of Chronic Viral Hepatitis, Second Edition

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Epstein-Barr Virus: Pushing beyond one’s limits. In this disease, the cartilage gradually wears away and changes occur in the adjacent bone. By the way, HYPOCHOLESTEROLEMIA is usual in liver disease too (unless the primary problem is obstruction of bile flow -- why?), since the liver isn't producing LDL's. (This is part of the reason for the silly myth that "too low cholesterol is bad for you".) COAGULOPATHY of liver disease (NEJM 365: 147, 2011) results from diminished hepatic synthesis of factors II, V, VII (first to go), IX, and X. (Note that absent vitamin K from malabsorption also prevents synthesis of II, VII, IX, and X.) Monitor all this by following the prothrombin times (rather than PTT, since factor VII is first to go and to return).

Pages: 208

Publisher: CRC Press; 2 edition (December 29, 2004)


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