Jaundice - Yellowing of the skin or sclera from bilirubin being absorbed into the blood stream, Asterixis - Flappy or tremors in the hands caused by ammonia on the brain, Ammonia - a toxin that happens when the GI system breaks down protein, Altered Level of Consciousness - First sign of hepatic encephalopathy - REPORT TO PROVIDER, Fruity/ acetone breath - A symptom of ammonia build up - a sign of hepatic encephalopathy, Asities - third spacing of fluid into the peritoneal space due to low albumin levels, Varices - When vessels are under high pressure due to portal vein hypertension, they can form these and be life threatening, Portal Vein - Carries blood from the GI tract, through the liver, back to the heart, Puritis - Severely itchy skin due to bile salt deposits under the skin / bilirubin in the blood stream, Pale stool - Due to bilirubin not being in the GI tract , Distaste for Cigarettes - Common with hepatitis infection, Easy bruising, purpura - Liver isn't making enough clotting factor - prothrombin, Gynecomastia / Abnormal periods - Liver is not metabolizing hormones correctly, Thrombocytopenia, Lukopenia, Anemia - Back up of blood into the spleen (splenomegaly) ,

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