f****i
发帖数: 129 | 1 20. 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 Indirect Alkaline
Bilirubin Bilirubin Phosphatase Reticulocyte
(mg/dL) (mg/dL) (U/L) (ALT, GPT) (U/L) Count (%)
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 | f****i
发帖数: 129 | 2 many people chose E and think it is alcoholic hepatitis. but why alcoholic
hepatitis has high direct bilirubin?? as I know from Goljan:
direct bilirubin<20%: hemolysis.
20-50%: hepatitis, including alcoholic and viral.
>50%:duct obstruction.
severe
Ultrasonography
【在 f****i 的大作中提到】
: 20. 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?
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