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Evaluation

Patient's age

years

Patient's gender

Does the patient feel tired after waking up, or while performing light physical tasks?

Does the patient note a lack of appetite, resulting in eating less than normally?

Does the patient show very tense ascites with intra-abdominal organs nonpalpable on physical exam?

Is there obvious distention of the abdomen due to ascites fluid?

Is the abdomen distended, with shifting or flank dullness and/or bulging, a fluid wave or puddle sign?

Is there generalized edema?

Is there severe pitting edema of legs or dependent portions?

Is there only slight pitting edema of ankle or dependent portions?

Are there many very prominent veins covering most of the abdominal wall?

Are there a few prominent veins in the flanks or over the anterior abdominal wall?

Are veins visible in the flanks or anterior abdominal wall?

Does the patient show signs of altered mental status or other evidence of hepatic encephalopathy?

Number of spider nevi present

Patient's prothrombin time

seconds

Prothrombin time for control

seconds

Patient's hematocrit(enter from 0 to 100)

percent

Serum albumin

Bilirubin

Alkaline phosphatase

Results

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