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This Concept Map, created with IHMC CmapTools, has information related to: Ethel Kardashian 2, Epigastric pain described as non-radiating, acetaldehyde which produces (via aldehyde dehydrogenase) acetate, CMP significant for elevated ALT 112.3IU/L, increased ethanol metabolism resulting in increased NADH/NAD+, increasing fatty acid synthesis which increases lipogenesis, reactive oxygen species which damages hepatocytes, damaged hepatocytes resulting in leakage of urobilinogen, acetyl CoA eventually resulting in increased B-hydroxybutarate from acetoacetate, oxaloacetate acts as substrate for gluconeogenesis, free fatty acids in plasma which increases increased B-hydroxybutarate from acetoacetate, lipogenesis resulting in fatty liver, urinalysis significant for 2+ ketones, Ethel Kardashian prescribed lisinopril, fatty liver due to chronic alcohol consumption, urobilinogen which cannot be processed and leads to jaundice (yellow), bilirubin diglucuronide (conjugated bilirubin) which forms bile, lab values including urinalysis, urinalysis significant for brown in color, Ethel Kardashian presents with sinus tachycardia, Ethel Kardashian presents with hepatic encephalopathy