08-30-2005, 05:22 PM
31. A 42-year-old woman comes to the physician for an annual pelvic examination and Pap smear. Over the past year, sha has had increasing fatigue and difficulty sleeping. She has two children who both attend college She is currently looking for part-time work outside the home. Her husband has been busy in a new start-up business Examination shows no abnormalities. Laboratory studies show:
Hemoglobin 15 gldL
Mean corpuscular volume 95 pm3
Leukocyte count 6000/mm3 with a normal differential
Serum
N 145 mEqlL
01 102 mEqlL
4 5 mEq/L
HCO 25mEq/L
Urea nitrogen (BUN) 18 mgldL
Creatinine 1 .0 mg/dL
Alkaline phosphatase 70 U/L
Aspartate aminotransferase
(AST, GOT) 22 U/L
Alanine aminotransferase
(ALT, GPT) 19 U/L
y-Glutamyltransferase
(GGT) 63 UIL
(N=5_50 U/L)
Which of the following is the most likely explanation for this patient™s laboratory abnormalities?
A) Acetaminophen
B) Alcohol
C) IDiphenhydramine
D) Estrogen effect
E) Ibuproten
Hemoglobin 15 gldL
Mean corpuscular volume 95 pm3
Leukocyte count 6000/mm3 with a normal differential
Serum
N 145 mEqlL
01 102 mEqlL
4 5 mEq/L
HCO 25mEq/L
Urea nitrogen (BUN) 18 mgldL
Creatinine 1 .0 mg/dL
Alkaline phosphatase 70 U/L
Aspartate aminotransferase
(AST, GOT) 22 U/L
Alanine aminotransferase
(ALT, GPT) 19 U/L
y-Glutamyltransferase
(GGT) 63 UIL
(N=5_50 U/L)
Which of the following is the most likely explanation for this patient™s laboratory abnormalities?
A) Acetaminophen
B) Alcohol
C) IDiphenhydramine
D) Estrogen effect
E) Ibuproten