Day 3 One factor contributing to ascites is a relative decrease in plasma protein, a situation that promotes edema. If this woman's cholelithiasis is severe, we might expect that she will have difficulty digesting and absorbing lipids. If this patient has difficulty digesting and absorbing lipids, then we expect that she will absorb less of her oral contraceptive. On the other hand, if this patient has cholelithiasis, we can infer that her liver is damaged and will metabolize hormones poorly. Extensive jaundice means that the patient has cholestasis too.
Extensive cholestasis means that the patient has jaundice too.
A patient may be jaundiced without any liver damage at all. You have to have a lot of cell death in order to see a complete loss of liver function. The more necrosis you have, the more ALT and AST you see in the blood. Since collagen contracts, we might expect a cirrhotic liver to be smaller than usual. Increasing cardiac sphincter tone will worsen heartburn because swallowing will be slower.