A 51-year-old welder is icteric with bitemporal wasting and

Discussion in 'USMLE Step 2 CK' started by Guest, Sep 27, 2009.

  1. Guest

    Guest Guest

    A 51-year-old welder presents complaining of severe fatigue and the onset of jaundice. He has a known history of hepatitis C, which he acquired after IV drug use 20 years earlier. Over the past 6 months, he has developed ascites and has had two admissions to the hospital for esophageal variceal bleeding. On physical examination, he is icteric with bitemporal wasting and multiple stigmata of chronic liver disease. On abdominal examination, his liver is 7 cm in the midclavicular line, and splenomegaly is present. There is near-tense ascites and moderately severe lower extremity edema, which extends to the mid-calf. Laboratory results reveal an albumin of 2.1 g/dL, total bilirubin of 12.1 mg/dL, and a prothrombin time of 19 seconds. Which of the following is the most appropriate therapy for this patient?

    A. Interferon
    B. Ribavirin
    C. Interferon plus ribavirin
    D. Mesocaval shunt
    E. Evaluation for liver transplantation
  2. Guest

    Guest Guest

    Ans: E. Evaluation for liver transplantation
  3. Guest

    Guest Guest

    E. Liver transplantation (if available) is the treatment of choice for patients with end-stage liver failure.

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