51 year old ciritically unwell man with shock and encephalopathy

His blood results show:

Mild thrombocytopaenia – alcohol, additional platelet dysfunction and coagulopathy likely

Elevated inflammatory markers – sepsis, liver failure

Liver failure secondary to alcohol abuse – AST:ALT 2:1, GGT increase >>>ALP increase, mild transaminitis

Reduced albumin – chronic nutritional and synthetic dysfunction of liver (in cirrhosis, often expect increased globulins)

Mild hyponatraemia – liver failure, ascites

Moderate to severe hypokalaemia – diarrhoea and vomiting

Hypochloraemic alkalosis – vomiting

Renal fai;lure – pre renal, ?hepatorenal

Examination Findings:

Vitals – RR, Temp

glucose, ketones

signs of chronic liver disease, cirrhosis, portal hypertension

Complications -sepsis, SBP etc

Ppt factors for encephalopathy – D and V, drugs, sepsis etc