04-28-2010, 03:01 PM
13. A 42-year-old woman comes to the physician for an annual pelvic examination and Pap smear. Over the past year, she 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 g/dL
Mean corpuscular volume 95 μm3
Leukocyte count 6000/mm3 with a normal differential
Serum
Na+ 145 mEq/L
Cl“ 102 mEq/L
K+ 4.5 mEq/L
HCO3“ 25 mEq/L
Urea nitrogen (BUN) 18 mg/dL
Creatinine 1.0 mg/dL
Alkaline phosphatase 70 U/L
Aspartate aminotransferase
(AST, GOT) 22 U/L
Alanine aminotransferase
(ALT, GPT) 19 U/L
γ-Glutamyltransferase
(GGT) 83 U/L
(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
) Diphenhydramine
D
) Estrogen effect
E
) Ibuprofen
Please help me make sense of this. I chose 'D' Estrogen bcz it causes cholestasis, but i see no reason for increased Estrogen, nor is there any hint she's on OCP.
Hemoglobin 15 g/dL
Mean corpuscular volume 95 μm3
Leukocyte count 6000/mm3 with a normal differential
Serum
Na+ 145 mEq/L
Cl“ 102 mEq/L
K+ 4.5 mEq/L
HCO3“ 25 mEq/L
Urea nitrogen (BUN) 18 mg/dL
Creatinine 1.0 mg/dL
Alkaline phosphatase 70 U/L
Aspartate aminotransferase
(AST, GOT) 22 U/L
Alanine aminotransferase
(ALT, GPT) 19 U/L
γ-Glutamyltransferase
(GGT) 83 U/L
(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
) Diphenhydramine
D
) Estrogen effect
E
) Ibuprofen
Please help me make sense of this. I chose 'D' Estrogen bcz it causes cholestasis, but i see no reason for increased Estrogen, nor is there any hint she's on OCP.
Thanks.