03-20-2007, 10:49 PM
A previously healthy 32-year-old man comes to the emergency
department because of a 12-hour history of fatigue and shortness of breath
at rest. He takes no medications. His temperature is 7 C (98.6 F), blood pressure is
96/58 mm Hg, pulse is 110/min, and respirations are 22/min. Examination shows
scleral icterus and conjunctival pallor. There is no hepatosplenomegaly. Laboratory
Studies show:
Hemoglobin 6.2 g/dL
Serum Leukocyte count 8800/mm3
Bilirubin, total 8.5 mg/dL
Reticulocyte count 16%
Direct 1.5 mg/dL
Platelet count 245,000/mm3
Lactate dehydrogenase 1260 U/L
A) Acute toxic hepatitis
B) Alcoholic hepatitis
C) Cholangiocarcinoma
D) Chronic idiopathic cirrhosis
E) Common bile duct calculus
F) Congestive hepatitis
G) Gallstone pancreatitis
H) Gilbert's syndrome
I) Infectious hepatitis
J) Intravascular hemolysis
K) Primary biliary cirrhosis
department because of a 12-hour history of fatigue and shortness of breath
at rest. He takes no medications. His temperature is 7 C (98.6 F), blood pressure is
96/58 mm Hg, pulse is 110/min, and respirations are 22/min. Examination shows
scleral icterus and conjunctival pallor. There is no hepatosplenomegaly. Laboratory
Studies show:
Hemoglobin 6.2 g/dL
Serum Leukocyte count 8800/mm3
Bilirubin, total 8.5 mg/dL
Reticulocyte count 16%
Direct 1.5 mg/dL
Platelet count 245,000/mm3
Lactate dehydrogenase 1260 U/L
A) Acute toxic hepatitis
B) Alcoholic hepatitis
C) Cholangiocarcinoma
D) Chronic idiopathic cirrhosis
E) Common bile duct calculus
F) Congestive hepatitis
G) Gallstone pancreatitis
H) Gilbert's syndrome
I) Infectious hepatitis
J) Intravascular hemolysis
K) Primary biliary cirrhosis