nbme 3 - abdominal pain - jorj

[ArchivalUser]

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 Bilirubin - Indirect Bilirubin - Alkaline Phosphatase - SGPT - Reticulocyte %

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


Can anyone tell me aslo what is the diagnosis ? I got lost here !

[ArchivalUser]

Acute Cholangitis?

[ArchivalUser]

But normal size hepatic ducts and tender liver ?? i think it is some sort of hepatitis, but I am not sure

[ArchivalUser]

I'm not sure too, but hepatic duct could be normal in the first 24h in acute cholangitis, and liver is tender.
e maybe the currect answer????

[ArchivalUser]

a, b and c can be safely excluded because alk ph and SGPT are normal. So we are left with d and e.

acute cholangitis will match (D) because alk. ph. is higher than SGPT

Hepatitis will match (E) because SGPT is higher than alk. ph.