Which of the following is not one of the physiologic changes noted in patients with cirrhosis?
A. Reduced resting energy expenditureThe clinical manifestations of cirrhosis are the result of numerous physiologic changes associated with a patient's progressive liver failure. Hypoalbuminemia results in finger clubbing, while spider angiomata and palmar erythema are thought to be caused by alterations in sex hormones. The physiologic basis for feminization of males (gynecomastia, loss of chest/axillary hair, testicular atrophy) with cirrhosis is less well understood. Portal hypertension manifests as caput medusa and varices. Cirrhotic patients suffer from chronic malnutrition, which may be associated with weakness, weight loss, and decreased fat and muscle stores. Despite this fact, patients with cirrhosis have elevated resting energy expenditure. Also noted are increased cardiac output and heart rate with decreased systemic vascular resistance and blood pressure.