11-16-2007, 09:04 AM
A 53-year-old postmenopausal woman has been feeling increasingly tired for 3 months. She has had mid-epigastric pain for the past month. On physical examination her stool is positive for occult blood. Laboratory findings include a WBC count of 6300/uL, Hgb 12.0 g/dL, Hct 35.5%, MCV 78 fL, platelet count 236,000/uL, total protein 6.0 g/dL, albumin 3.5 g/dL, alkaline phosphatase 270 U/L, AST 84 U/L, ALT 35 U/L, lipase 45 U/L, total bilirubin 1.1 mg/dL, and direct bilirubin 0.8 mg/dL. Which of the following is the most likely diagnosis?
A Hepatic metastases
B Wilson disease
C Acute hepatitis A
D Acetaminophen toxicity
E Congestive heart failure
F Chronic alcohol abuse
G Non-alcoholic fatty liver
A Hepatic metastases
B Wilson disease
C Acute hepatitis A
D Acetaminophen toxicity
E Congestive heart failure
F Chronic alcohol abuse
G Non-alcoholic fatty liver