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* Alcoholic
 #841862  
  cindyvic - 06/18/17 13:25
 
  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 Serum Bilirubin, Serum Indirect Bil, Serum Alkaline Phosphatase, Serum Alanine Aminotransferase, Reticulocyte
(mg/dL) (mg/dL) (U/L) (ALT, GPT) (U/L) Count (%)



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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* Re:Alcoholic
#3341313
  vadev - 06/18/17 14:08
 
  If he has cirrhosis obviously that Alat is increased->exclude A B C

D or E he is anemic probably D reticulocyte higher

ASAT:ALAT ratio >2:1 if ALAT 400 in alcoholic hepatitis less likely ASAT 800
 
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