Bimonthly internal assessment
Case 1: Q1 What is the Reason for this patients ascites ? The most common cause of Ascites is Cirrhosis of liver risk factors in this patient : 1. Chronic alcoholism since 40 years 2. Truncal obesity leading to metabolic syndrome causing NAFLD leading to cirrhosis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092576/ Altered echo texture of liver due to Cirrhosis causes portal hypertension leading to increased hydrostatic pressure causing fluid accumulation hence Ascites Q2 Bilateral pedal oedema which is of pitting type is due to decrease in the albumin level trends due to course of the disease and long standing cirrhosis causing decrease in the production of proteins causing decrease in the oncotic pressure leading to accumulation of fluid. as per the given clinical data due to chronic liver disease there was increasing trend of INR which was as high as 4.7 causing bleeding manifestations ( bleeding gums, hematoma formation ) ulcerations a