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  #1  
Old 12-19-2011
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Liver Alcoholic Liver Function Tests!

A 47-year-old woman comes to the emergency department because of severe abdominal pain for 3 hours. The pain began after a 2-week drinking binge. She has a 15-year history of alcoholism. She has no history of jaundice or hepatitis. Current medications include multivitamins and iron. Her temperature is 38C (100.4F), blood pressure is 110/80 mm Hg, and pulse is 110/min. Examination shows mild jaundice and diffuse spider angiomata over the trunk and abdomen. The liver is tender to palpation. A complete blood count shows mild anemia with normal red cell indices. Ultrasonography of the abdomen shows normal-sized hepatic ducts. Which of the following is the most likely set of laboratory findings?

Total Bilirubin (mg/dL) // Indirect Bilirubin (mg/dL) // ALP // GPT // Reticulocyte (%)
A) 2 // 0.9 // 80 // 30 // 1.2
B) 3 // 2.8 // 70 // 30 // 1.0
C) 3 // 2.8 // 80 //20 // 3.0
D) 4 // 2.0 // 800 //200 // 1.5
E) 4 // 1.0 // 150 //400 // 1.0
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Old 12-19-2011
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A case of alcoholic hepatitis and the answer is E).
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No.. I dont agree with that.. Q stem says patient has mild jaundice and fever.. Fever not seen in alcoholic hepatitis i think
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Old 12-19-2011
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actually patients with alcoholic hepatitis present with nonspecific symptoms and a low grade fever is one of them..check it. still going with E.
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i am with E
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Old 12-19-2011
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the answer should be E)

E) 4 // 1.0 // 150 //400 // 1.0

Patients who are severely affected present with subacute onset of fever, hepatomegaly, leukocytosis, marked impairment of liver function (eg, jaundice, coagulopathy), and manifestations of portal hypertension (eg, ascites, hepatic encephalopathy, variceal hemorrhage). However, milder forms of alcoholic hepatitis often do not cause any symptoms.
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Old 12-20-2011
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I just want to bring another idea on the table.. Why cant it be ascending cholangitis?? There are features for that i.e charcots triad.. fever, jaundice and abd pain..??
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Old 12-20-2011
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Quote:
Originally Posted by bassatom View Post
I just want to bring another idea on the table.. Why cant it be ascending cholangitis?? There are features for that i.e charcots triad.. fever, jaundice and abd pain..??
because the pain began after a 2-week drinking binge and she is an alcoholic....if one changes the story, of course this could be something else
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