gi tract conditions

Question 1

what is gastro-esophageal reflux? (acid reflux)

Answer 1

a condition in which stomach acid repeatedly flows back up into the tube connecting the mouth and stomach, called the esophagus. It’s often called GERD for short. This backwash is known as acid reflux, and it can irritate the lining of the esophagus.

Question 2

what are symptoms of acid reflux?

Answer 2

A burning sensation in the chest, often called heartburn. Heartburn usually happens after eating and might be worse at night or while lying down.
Backwash of food or sour liquid in the throat.
Upper belly or chest pain.
Trouble swallowing, called dysphagia.
Sensation of a lump in the throat.

If you have nighttime acid reflux, you also might experience:

An ongoing cough.
Inflammation of the vocal cords, known as laryngitis.
New or worsening asthma.

Question 3

what causes acid reflux?

Answer 3

when the sphincter at the bottom of the esophagus doesnt relax, stomach acid can flow back into the esophagus. this can cause the esophagus to become inflammed

Question 4

what are some conditions which can increase the risk of acid reflux?

Answer 4

obesity,
bulging of the top of the stomach above the diaphragm (hital hernia)
pregnancy
connective tissue dissorders such as scleroderma
delayed stomach emptying

Question 5

what are factors which can aggravate acid reflux?

Answer 5

Smoking.
Eating large meals or eating late at night.
Eating certain foods, such as fatty or fried foods.
Drinking certain beverages, such as alcohol or coffee.
Taking certain medicines, such as aspirin.

Question 6

what treatments are used for acid reflux?

Answer 6

Prescription-strength proton pump inhibitors (PPIs) work by inhibiting certain stomach cells from “pumping” acid into the stomach

H2 blockers which provide relief from indigestion, stomach pain, heart burn and reflux, nausea and vomiting and sour stomach

Question 7

what is Mallory Weiss tear?

Answer 7

a split in the inner layer of your esophagus caused by forceful vomiting, retching or straining- causing bleeding. occur near where the esophagus meets the stomach

Question 8

what are symptoms of mallory weiss tears?

Answer 8

the most common symptom is vomiting blood
other symptoms are:
dark sticky tools,
dizziness,
fainting.

Question 9

what are the complications of mallory weiss tars?

Answer 9

if untreated can cause:
amnemia (deficiency of healthy red blood cells), fatigue and shortness of breath, dizziness, abdominal or chest pain.

If the tear is severe and internal bleeding occurs, you may experience symptoms of shock such as:

Anxiety or agitation.
Dry mouth or thirst.
Nausea.
Pale, cold and clammy skin.
Rapid heartbeat or heart palpitations.

Question 10

what is the treatment of mallory weis tears?

Answer 10

h2 receptor blockers-which provide relief from indigestion, stomach pain, heart burn and reflux, nausea and vomiting and sour stomach

proton pump inhibitors- Decrease stomach acid production
Relieve symptoms of chronic acid reflux (GERD) and stomach ulcers

Self limiting in 80-90% of cases (stop bleeding and heal on its own)
injection or a heat treatment to stop bleeding
Surgical repair (rare)

Question 11

what is the diagnosis of mallory weiss tear?

Answer 11

sign & symptoms
stool test
upper GI endoscopy

Question 12

what is hiatus hernia?

Answer 12

A hiatus Hernia is when part of the stomach moves up through a small opening (hiatus) in the diaphragm into the chest.
A hernia is when any organ or tissue pushes through a weakness in the tissue barrier that normally contains it.

Question 13

what are the 4 types of hital hernias?

Answer 13

type 1- mst common. the part of your esophagus that connects to your stomach slides up through the widened hiatus at times and then slides back down.

type 2-the upper part of your stomach pushes up through the hiatus alongside your esophagus, forming a bulge next to it. This is also called a rolling hiatal hernia.

type 3- mix of type 1 and 2.The part of your esophagus that connects to your stomach — the gastroesophageal junction — slides up through the hiatus at times. And another part of your stomach also bulges through, alongside the gastroesophageal junction at times.

type 4-The hernia involves your stomach together with another abdominal organ, such as one of your intestines, your pancreas or your spleen.

Question 14

what are the risk factors of a hiatus hernia?

Answer 14

age-related changes in diaphragm (common over 50)

pregnancy

obesity

exercising and heavy weight lifting

persistence and intense pressure on surrounding muscles caused by severe coughing, vomiting, straining during the bowel movement

Question 15

what are the signs and symptoms of hiatus hernia?

Answer 15

Heartburn (GORD) (painful burning sensation in the chest often after eating) due to acid reflux

shortness of breath

regurgitation of food or liquid into mouth

burping and feel bloated

feeling full soon after eat

nausea and vomiting

dysphagia (difficulty swallowing)

vomiting of blood or passing of black stool

Question 16

what is the treatment of hiatus hernia?

Answer 16

life style changes
- change eating habits
- avoid lying down at least 3 hours after eating or drinking
- stop smoking

teating GORD symptoms
keyhole surgery (laparoscopy) in severe cases (in case of paraoseophageal hernia

Question 17

what is the diagnosis of hiatus hernia?

Answer 17

xray, endoscopy

Question 18

what is achlorhydria?

Answer 18

reduction in stomach acid and pepsinogen secretion.

It’s a more severe form of a hypochlorhydria, a deficiency of stomach acids. Both conditions can impair the digestive process and lead to damage of the gastrointestinal system. Without stomach acid, your body won’t properly break down protein.

Question 19

what are symptoms of achlorhydria?

Answer 19

iron deficiency anemia- without stomach acids the body will have issues absorbing iron
abdominal bloating
indigestion
nausea
acid reflux
digestive issues
diarrhea
weak, brittle nails
hair loss
undigested food in stools

Question 20

what are the causes of achlorhydria?

Answer 20

gastric muscosal atrophic- the process of chronic inflammation of the gastric mucosa of the stomach.
hypothryoidism- slows down your metabolism, resulting in a decrease of gastric acid production.

Question 21

what are the treatments from achlorhydria?

Answer 21

infection- antibiotics
nurtitional supplements.

Question 22

what are peptic ulcers?

Answer 22

open sores on the inner lining of the stomach and upper part of the small intestine.
peptic ulcers include:
Gastric ulcers, which appear on the inside of the stomach.
Duodenal ulcers, which appear on the inside of the upper part of the small intestine, called the duodenum.

Question 23

what are the symptoms of peptic ulcers?

Answer 23

Dull or burning stomach pain. For some people, pain may be worse between meals and at night. For others, it may be worse after eating.
Feeling of fullness or bloating.
Belching.
Heartburn.
Nausea.

peptic ulcers can cause bleeding from the ulcer the symptoms may include:
vommiting blood,
having dark blood in stools,
feeling dizzy or fainting

Question 24

what are the causes of peptic ulcers?

Answer 24

Peptic ulcers happen when acid in the organs that food travels through, called the digestive tract, eats away at the inner surface of the stomach or small intestine.

helicobacter pylori- a germ living in the mucous layer that covers and protects tissues that line the stomach and small intestine.can cause swelling and irritation, called inflammation, of the stomach’s inner layer. When this happens, it can cause an ulcer.

regular use of certain pain relievers: taking asprin or anti flammatory drugs can irrate or infame the lining of the stomach and small inestine

Question 25

what are complications of a peptic ulcer?

Answer 25

bleeding in the stomach or duodenum, a hole called a perforation in the stomach wall, blockage, stomach cancer

Question 26

what are treatments used for peptic ulcers?

Answer 26

antibiotics to kill h pylori, medicanes that block acid, (Acid blockers, also called histamine (H-2) blockers, help relieve ulcer pain and help with healing.) medicanes to reduce stomach acid, (PPIs allow the petic ulcers to heal) Medicines that protect the lining of the stomach and small intestine.

Question 27

what is gastroparesis?

Answer 27

Gastroparesis is a condition in which the muscles in the stomach don't move food as they should for it to be digested.

Question 28

what are the symptoms of gastroparesis?

Answer 28

Vomiting. Nausea. Belly bloating. Belly pain. Feeling full after eating just a few bites and long after eating a meal. Vomiting undigested food eaten a few hours earlier. Acid reflux. Changes in blood sugar levels. Not wanting to eat. Weight loss and not getting enough nutrients, called malnutrition.

Question 29

what causes gastroparesis?

Answer 29

not always clear but sometimes damage to a nerve that controls the stomach muscles can cause it- vagus nerve

Question 30

what are the risk factors of gastropariesis?

Answer 30

Diabetes. Surgery on the stomach area or on the tube that connects the throat to the stomach, called the esophagus. Infection with a virus. Certain cancers and cancer treatments, such as radiation therapy to the chest or stomach. Certain medicines that slow the rate of stomach emptying, such as opioid pain medicines. A condition that causes the skin to harden and tighten, called scleroderma. Nervous system diseases, such as migraine, Parkinson's disease or multiple sclerosis. Underactive thyroid, also called hypothyroidism.

Question 31

what are the complications of gastroparesis?

Answer 31

loss of body fluids- dehydration due to vommiting malnutrition food that doesnt digest that hardens and stays in the stomach, blood sugar changes

Question 32

what is the treatment of gastroparesis?

Answer 32

changes to your diet, medications to help the stomach muscles work (Metoclopramide). medicines to control nausea and vomiting. feeding tube through the nose or mouth directly into the small intestine

Question 33

how is gastroparesis diagnosed?

Answer 33

Gastric Emptying Study (GES) using radioactive material traced by a scanner Upper endoscopy Barium x-rays Wireless motility capsules (SmartPill)

Question 34

what is jaundice? why does it happen

Answer 34

when your skin and the whites of your eyes (mucous membranes) turn yellow. this is when the liver is unable to process bilirubin (a yellow substance made when red blood cells break down) in your blood. caused byy too much red blood cell breakdown or liver injury.

Question 35

what causes jandice?

Answer 35

prehapatic jaundice- to much red blood cell breakdown take over your livers ability to filter out bilirubin from your blood. hepatic jaundice- during the production of bilirubin. This type happens when your liver can’t remove enough bilirubin from your blood. Hepatic jaundice can happen if you have liver failure. posthepatic jaundice-Also called obstructive jaundice, this type happens when a blockage stops bilirubin from draining into your bile ducts.

Question 36

what are the causes of prehepatic jaundice?

Answer 36

,Breaking down a large hematoma (bruise, A pool of mostly clotted blood that forms in an organ, tissue, or body space) and then reabsorbing it back into your bloodstream. Hemolytic anemias (when blood cells are destroyed and removed from the bloodstream before their normal lifespan is over).

Question 37

what are hepatic jaundice causes?

Answer 37

Viruses, including hepatitis A, chronic hepatitis B and C, and Epstein-Barr virus infection (infectious mononucleosis). Alcohol-induced hepatitis. Autoimmune disorders. Rare genetic metabolic defects. Medicines, including penicillin, oral contraceptives, chlorpromazine (Thorazine R), estrogenic or anabolic steroids and acetaminophen toxicity.

Question 38

what are posthepatic jaundice causes?

Answer 38

Gallstones. Inflammation (swelling) of your gallbladder. Gallbladder cancer. Pancreatic tumor.

Question 39

what are symptoms of jaundice?

Answer 39

Yellowish tint to your skin and the whites of your eyes. Fever. Chills. Pain in your belly. Flu-like symptoms. Dark-colored pee. Pale-colored poop. Being tired or confused. Itchy skin. Weight loss.

Question 40

what is cirrhosis?

Answer 40

severe scaring of the liver.be caused by many forms of liver diseases and conditions, such as hepatitis or chronic alcoholism.

Question 41

what are the symptoms of cirrhosis?

Answer 41

often no symptoms until the liver damage is severe. Fatigue. Easily bleeding or bruising. Loss of appetite. Nausea. Swelling in the legs, feet or ankles, called edema. Weight loss. Itchy skin. Yellow discoloration in the skin and eyes, called jaundice. Fluid accumulation in the abdomen, called ascites (uh-SAHY-teez). Spiderlike blood vessels on the skin. Redness in the palms of the hands. Pale fingernails, especially the thumb and index finger. Clubbing of the fingers, in which the fingertips spread out and become rounder than usual. For women, absence of or loss of periods not related to menopause. For men, loss of sex drive, testicular shrinkage or breast enlargement, known as gynecomastia. Confusion, drowsiness or slurred speech.

Question 42

what are the causes of cirrhosis?

Answer 42

Long-term alcohol abuse. Ongoing viral hepatitis (hepatitis B, C and D). Nonalcoholic fatty liver disease, a condition in which fat accumulates in the liver. Hemochromatosis, a condition that causes iron buildup in the body. Autoimmune hepatitis, which is a liver disease caused by the body's immune system. Destruction of the bile ducts caused by primary biliary cholangitis. Hardening and scarring of the bile ducts caused by primary sclerosing cholangitis. Wilson's disease, a condition in which copper accumulates in the liver. Cystic fibrosis. Alpha-1 antitrypsin deficiency. Poorly formed bile ducts, a condition known as biliary atresia. Inherited disorders of sugar metabolism, such as galactosemia or glycogen storage disease. Alagille syndrome, a genetic digestive disorder. Infection, such as syphilis or brucellosis. Medications, including methotrexate or isoniazid.

Question 43

what are the 3 stages of alcohol liver disease?

Answer 43

alcoholic fatty liver disease (first stage) where fat starts to accumulate around the liver. acute alcoholic hepatitis: causes inflammation (swelling) of the liver in this stage. the outcome depends on the severity of damage. alcoholic cirrhosis- liver is scared from alcohol abuse and can lead to liver failure.

Question 44

what are symptoms of ARLD?

Answer 44

nausea loss of appetite jaundice fatigue abdominal discomfort increased thirst swelling in the legs and abdomen weight loss darkening or lightening of the skin red hands or feet dark bowel movements

Question 45

whats the diagnosis and treatment for ARLD?

Answer 45

liver function test, ct scan, abdominal ultra sound, liver biopsy. NA to help stop drinking, multivitamins, liver transplant, vitamin a supplements.

Question 46

what are gallstones?

Answer 46

hardened deposits of digestive fluid that can form in your gall bladder.

Question 47

what are symptoms of gall stones?

Answer 47

Sudden and rapidly intensifying pain in the upper right portion of your abdomen Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone Back pain between your shoulder blades Pain in your right shoulder Nausea or vomiting

Question 48

what are the causes of gallstones?

Answer 48

the bile containing to much cholesterol, the bile containing to much bilirubin, the gall bladder doesnt empty correctly

Question 49

what is the diagnosis and treatment of gallstones?

Answer 49

abdominal ultrasound, endoscopin ultrasound other imaging tests- CT blood tests surgery to move the gallbladder, medications to dissolve gallstones- which dont contain calcium. Endoscopic retrograde cholangio-pancreatography (ERCP) which removes gallstones from bile ducts

Question 50

what is acute pacreatitis?

Answer 50

inflammation of the pancreas. it occurs suddenly and causes pain in the upper abdominal region. the pain often radiates to your back.

Question 51

what are the causes of acute pancreatitis? direct and indirect

Answer 51

direct causes: sudden immune system attacks on the pancreas, or autoimmune pancreatitis pancreatic or gallbladder damage from surgery or injury excessive fats called triglycerides in your blood. indirect causes: alcohol abuse, cystic fibrosis, a serious condition that affects your lungs, liver, and pancreas Kawasaki disease, a disease that occurs in children younger than 5 years old viral infections like mumps and bacterial infections like mycoplasma Reye’s syndrome, a complication from certain viruses that can also affect the liver certain medications containing estrogen, corticosteroids, or certain antibiotics

Question 52

what are symptoms of acute pancreatisis?

Answer 52

pain within minutes of drinking or eating food pain spreading from your abdomen to your back or left shoulder blade area pain that lasts for several days at a time pain when you lie on your back, more so than when sitting up fever nausea vomiting sweating jaundice (yellowing of the skin) diarrhea bloating

Question 53

what is the diagnosis and treatment of acute pancreatitis?

Answer 53

blood tests looking for: increased lipase, amylase level increased alkaline phosphatase level increased bilirubin level increased WBC count hypocalcaemia and scans- ultrasound, CT, MRI. fluids, medication for pain, removal of the gall blader

Question 54

how does biliary obstruction cause acute pancreatitis?

Answer 54

Presence of stone in the common bile duct or sphincter of Oddi Causes bile and pancreatic juice to mix and backflow into pancreatic tissue This causes inactive proteases to become activated and start of the auto-digestion of pancreatic tissue Auto-digestion leads to oedema and ischemic injury to the pancreatic tissue This would cause pancreatitis.

Question 55

how can alcohol, drugs, trauma, viruses or ischemia causes acute pancreatisis?

Answer 55

Leads to intracellular activation of proteases enzymes i.e. trypsinogen into trypsin The activation of proteases lead auto-digestion of pancreatic tissue and pancreatitis.

Question 56

what is pernicious Anemia?

Answer 56

autoimmune condition that prevents the body from absorbing vitamin B12. this results in fewer red blood cells carrying oxygen throughout the body.

Question 57

how can pernicious anemia cause problems to the body?

Answer 57

can cause problems such as nausea, bloating and weight loss in digestive system. muscle weakness, numbness or tingling in the hands and feet, memory loss and dementia. heart problems that can cause palpitations (heart beating to fast or skipping beats). weakness and faituge.

Question 58

what causes pernicious anemia?

Answer 58

an autoimmune condition that happens when your immune system produces antibodies that attack cells in the mucosal lining of your stomach and nerve cells. Your immune system’s response affects your body’s ability to absorb vitamin B12.

Question 59

how is pernicious anemia treated?

Answer 59

with IM vitamin b12 injection. high doses of oral B12 replacement. prescribe antibiotics if it is the bacteria in the intestine that prevents your body from absorbing vitamin B12.

Question 60

what are the signs and symptoms of pernicious anaemia?

Answer 60

fatigue, lethargy (unusual decrease in consciousness), dyspnea (SOB), palpations, syncope (passing out) headache. paraesthesia (tingling), numbess, cognitive changes, visual disturbance.

Question 61

what is Hernia?

Answer 61

a bulge through an opening or weakness in the muscle or tissue that contains it. most hernias involve one of your abdominal organs pushing through one of the walls of your abdominal cavity.

Question 62

what are the different types of hernias?

Answer 62

inguinal hernia- most common, affect males, happens when part of the bowel protudes into your inguinal canal. passageway that runs down your inner thigh. femoral hernia- occurs in the femoral canal. which runs underneath the inguinal canal. hiatal hernia- common. when the opening of the diaphragm where the esophagus passes throgh widens and the top of your stomach pushes up through the opening of the chest. congenital diaphragmatic hernia: serious birth defect. the diaphragm doesnt close all the way during the fetal development. causing abdominal organs to slip up the chest cavity. incisional hernia- when tissue protudes through a former incision. umbilical hernia- when part of the intestine pokes through an opening in your abdominal wall near the belly button. vetral hernia- through the front wall of the abdomen. above the belly button. perinal hernia- organs or tissue push through an opening or weakness in your pelvic floor into the abdominal cavity.

Question 63

what can make you more likely to develop a hernia?

Answer 63

chronic cough, chronic constipation, history of abdominal or pelvic surgery, pregnancy, chronic obesity, job that involves heavy lifting or many hours of standing.

Question 64

how would you treat a hernia?

Answer 64

surgery. hernia repair- pushing the tissue back into place. using stitches to reinforce the barrier.

Question 65

what is a adhesion?

Answer 65

bands of scar tissue that form between the organs in the belly and pelvis. mainly forming loops of your small intestine. they can also form between an organ and the wall of your abdominal cavity.

Question 66

what are symptoms of abdominal adhesions?

Answer 66

severe abdominal pain, cramping, bloating, nausea and vomiting, abdominal distension (when your abdomen swells outward) obstipation (being unable to pass gas or poo)

Question 67

what are the causes of abdominal adhesions?

Answer 67

they from after your body repairs injured tissue inside your abdominal cavity. internal scars.If an organ or tissue inside your abdominal cavity is damaged, your immune system triggers inflammation to heal the tissue. As part of the healing process, the damaged tissue forms scar tissue. 75% causes from surgery. or can cauuse from conditions which make your abdominal inflammed

Question 68

what is intussusception?

Answer 68

a segment of your intestine (normally small intestine) folds partially inside the other. causing a bowel obstruction (blockage). can slow blood flow and prevent food from passing through it. can lead to swelling and inflammation that leads to life threatening complications.

Question 69

what are the symptoms of intussusception?

Answer 69

in children: episodes of severe, constant cramp abdominal pain, swollen belly, nausea & vomiting, red like stools in adults: adominal pain which comes and goes, vomiting, bloating and bloody stools.

Question 70

what is the treatment for intussusception?

Answer 70

in children using an contrast enema to stratighten out the childs intestine. in adults- surgery

Question 71

what is volvulus?

Answer 71

occurs when part of the intestine loops around and folds over. this can cut of the tissues blood supply leading to symptoms such as extreme pain, bloody stool and bowel obstruction

Question 72

what is bowel cancer?

Answer 72

a growth of cells that begins in a part of the large intestine called the colon (the first and longest part of the large intestine) or rectrum.

Question 73

what are symptoms of bowel cancer?

Answer 73

bleeding from the rectrum or blood in your poo, a change in normal bowel habit such as looser poo, constipation, a lump which can be felt in your back passage or abdomen (right side more common), strain in the rectrum (needing to poo) loosing weight, pain in the abdomen or back passage, tiredness and breathlessness causes by a lower than normal level of red blood cells. Sometimes cancer can block the bowel. This is called a bowel obstruction. The symptoms include: cramping pains in the abdomen feeling bloated constipation and being unable to pass wind being sick

Question 74

whats the diagnosis of bowel cancer? and treatment?

Answer 74

removing a sample of tissue for testing, blood tests, a scope to examine inside the colon. removing polyps-polypectomy, endoscopic mucosal resection- remove larger polyps. laparoscopic surgery-removes polyps that cannot be removed during a coloscopy..

Question 75

what is appendicitis?

Answer 75

the appendix swelling, muscosal secreations increase intraluminal pressure. pressure exceeds capillary perfusion causing venous and lymphatic obstruction.

Question 76

how does the appendix get blocked in appendicitis?

Answer 76

lymphoid hyperplasia, (increase number of lymphoid cells) infections, fecaliths (mass of hard stone like dry feces) tumours.

Question 77

what are signs and symptoms of appendicitis?

Answer 77

epigastric pain (pain or discomfort below the ribs and upper abdomen area), cramping sensation, right lower quadrant pain, nausea, vomiting, diarrhea, fever- high temp

Question 78

what is diabetes?

Answer 78

happens when your blood sugar (glucose ) is to high. when the pancreas doesnt make enough insulin or non at all. no insulin= glucose building up in the blood stream- high blood sugar- hyperglycemia.

Question 79

what are the different types of diabetes?

Answer 79

type 1-autoimmune disease in which your immune system attacks and destroys insulin producing cells. type 2- body doesnt make enough insulin

Question 80

what are symptoms of diabetes?

Answer 80

increased thirst, frequent urination, fatigue, blurred vision, unexplained weight loss, numbness or tingling in ur hands or feet,

Question 81

what causes diabetes?

Answer 81

to much glucose circulating in the blood stream. insulin resistance due to lack of physical activity, diet, hormonal imbalences, genetics and certain medications. autoimmune disease- type 1 when the immune system attacks the insulin-producing cells in the pancreas hormonal imbalance- the placental releases hormones that can cause insulin resistance. pancreatic damage- physical damage to the pancreas from a condition, surgery or injury, impact it making insulin. genetic mutatations

Question 82

what are the complications of diabetes?

Answer 82

hyperglycemic state- type 2 mainly. when your blood sugar levels are really high for a long period. leading to severe dehydration and confusion. DKA-mainly type 1 diabetes. if your body doesnt have enough insulin, it cannot use glucose for energy so it breaks down fat instead. which releases ketones which turns your blood acidic. causing vomiting and loss of consciousness. severe hypoglycemia- affects people who use insulin.

Question 83

what does insulin do? and what cells are they?

Answer 83

reduces blood glucose levels beta cells

Question 84

what does glucagon do? and what cells are they?

Answer 84

increases blood glucose levels alpha cells

Question 85

what is DKA? symptoms treatment

Answer 85

when the blood becomes acidic because the body breaks down fat instead. which releases ketones which turns your blood acidic. causing vomiting and loss of consciousness. this can lead to kussmaui respiration: depp labored breathing, reduced co2, reduce acidity. treatment: fluids, insulin (reduce blood glucose), electrolytes.

Question 86

what is acute liver failure?

Answer 86

when the liver looses function in days or weeks

Question 87

what causes acute liver failure?

Answer 87

extensive damage to liver cells where tissue can no longer function. - paracetomol overdose -herbal suppliments -meds such as antibiotics-toxins -hepatitis -fatty liver -shock -cancer -autoimmune disease herpes, epstein

Question 88

what are symptoms of liver failure?

Answer 88

nausea and vommiting jaudience sleepiness pain in the right upper abdo tremors confusion abdo swelling