USMLE Forum Archives - USMLE Step 3 - bloody vomit
bloody vomit
harry206 - 05-07-09 08:08
55-year-old African-American male is brought to your office by his concerned family members because of "the bloody vomit he had about two days ago." He never had any episodes of hematemesis in the past. He admits to being a chronic alcoholic for the past twenty years; however, he stopped drinking two years ago, after being enrolled in a rehabilitation program. His vital signs are stable. Pertinent physical findings on examination are spider angiomata over the chest, 2+ peripheral edema, and mild hepatomegaly. His chest and cardiovascular examination are normal. His laboratory test results show the following:
total bilirubin: 2.6 mg/dl
AST: 40 IU/L
ALT: 50 IU/L
GGT: 39 IU/L
alkaline phosphatase: 170 IU/L
serum albumin 2.8 g/dl
PT: 16 seconds
viral serology: negative
An ultrasonogram of the abdomen shows minimal free fluid in the abdomen. A liver biopsy is done, which shows findings suggestive of micronodular cirrhosis. Which of the following is the most appropriate treatment for this patient?
harry206 - 05-07-09 08:08
55-year-old African-American male is brought to your office by his concerned family members because of "the bloody vomit he had about two days ago." He never had any episodes of hematemesis in the past. He admits to being a chronic alcoholic for the past twenty years; however, he stopped drinking two years ago, after being enrolled in a rehabilitation program. His vital signs are stable. Pertinent physical findings on examination are spider angiomata over the chest, 2+ peripheral edema, and mild hepatomegaly. His chest and cardiovascular examination are normal. His laboratory test results show the following:
total bilirubin: 2.6 mg/dl
AST: 40 IU/L
ALT: 50 IU/L
GGT: 39 IU/L
alkaline phosphatase: 170 IU/L
serum albumin 2.8 g/dl
PT: 16 seconds
viral serology: negative
An ultrasonogram of the abdomen shows minimal free fluid in the abdomen. A liver biopsy is done, which shows findings suggestive of micronodular cirrhosis. Which of the following is the most appropriate treatment for this patient?
The correct answer and explanation will be available after you answer.
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#27
Re: bloody vomit babbu5508 - 09-30-10 16:21 My answer is: b.
Prescribe him octreotide for hematemesis from bleeding esophageal varices which is likely to recur unless underlying condition corrected.
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