Pancreatitis/Hepatitis Part 2

When he returned home, Luke followed his diet and took his meds
and began to feel better. He stayed off the alcohol for a while,
but then started to drink again. He drank smaller amounts, though,
and for several months managed to continue to work and function
pretty normally. Then, in 2001 the stock market plummeted and Luke
lost all of his investments.    He started drinking
very heavily again. He began having moderate abdominal pain, and
vomited nearly every day. After a few weeks of this, he began to
hallucinate and became verbally abusive to customers at work. His
boss called 911, and the paramedics took him to the emergency room.
Dr. Bennett admitted Luke. Following are some results of exams Dr.
Bennett ordered:

Height: 5’11

Weight: 150 lbs

Laboratory Tests

Dr. Bennett diagnosed Luke with all of the following
conditions:

Pancreatitis

Cirrhosis of the liver

Hepatic encephalopathy

Portal hypertension

Ascites

Pedal edema

He again ordered “NPO,” and the following medications:

Lasix (loop diuretic)

Lactulose (to reduce ammonia produced by gut bacteria)

Total Parenteral Nutrition (IV nutrients)

QUESTIONS:

1. Before Luke was required to be NPO, he was eating poorly in
general. He mostly ate donuts at work, and then drank when he went
home. Describe the process of absorption of carbohydrates from the
lumen of the small intestine until it reaches a hepatocyte. Include
the layers of the intestinal tract that are involved in this
process, and the vessels leading to the liver and to the
hepatocytes.

2. How does the absorption of fats differ from carbohydrates?
Describe the same process of absorption of fats from the lumen of
the small intestine until it reaches the hepatocyte. Include the
layers of the intestinal tract that are involved, and all of the
vessels leading to the liver and hepatocytes.

3. What hormones affect the response of the digestive system to
fats? How might these affect the liver’s reaction?

4. Describe the actions of the drugs prescribed. How will each
help improve the situation?

5. Explain why Luke’s pH was 7.50. What would Dr. Bennett call
this? How would Dr. Bennett know whether the problem was metabolic
or respiratory in origin?