mild jaundice and diffuse spider angiomata

Discussion in 'USMLE STEP 2 CS' started by Heena., May 19, 2008.

  1. Heena.

    Heena. Guest

    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 38°C (100.4°F), 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 Indirect Alkaline
    Bilirubin Bilirubin Phosphatase Reticulocyte
    (mg/dL) (mg/dL) (U/L) (ALT, GPT) (U/L) Count (%)

    O A) 2 0.9 80 30 1.2
    O B) 3 2.8 70 30 1.0
    O C) 3 2.8 80 20 3.0
    O D) 4 2.0 800 200 1.5
    O E) 4 1.0 150 400 1.0
  2. Guest

    Guest Guest

    it should be eeee...patient has got alcoholic hepatitis with normal duct system.....there should a mixed picture of bilirubin.....for jaundice to be clinically evident it should be more than or equal to 3...thats takes out option aaaa...there is no obstruction...so alkaline phosphatase should be normal...now we can exclude option dddd...considering its acute alcoholic hepatitis..you would expect the ALT to be up

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