A 55-year-old woman with cirrhosis from hepatitis C presents with easy bruising and epistaxis. Vital signs: BP 110/70, HR 88, RR 16, Temp 37°C, SpO2 98%. PT/INR is severely prolonged at 3.2. Labs show serum albumin 2.1 g/dL, total bilirubin 4.2 mg/dL, and platelet count 95,000/μL. Abdominal ultrasound confirms cirrhosis without ascites. She denies alcohol use. Which lipid-related hepatic synthetic process is most directly impaired?
- A)HDL-mediated reverse cholesterol transport
- B)Synthesis of apolipoprotein and clotting factorsGABARITO
- C)Esterification of free fatty acids in adipose tissue
- D)Absorption of dietary cholesterol in the intestine
- E)Peripheral lipolysis via hormone-sensitive lipase
Explicação
The liver synthesizes nearly all major apolipoproteins (A-I, B-100, C-II, E) and clotting factors (II, V, VII, X). Severe hepatic dysfunction impairs both protein synthesis pathways simultaneously, explaining coagulopathy and lipid abnormalities. Low albumin a... Ver explicação completa e trilha adaptativa →