USMLE Forum Archives - USMLE Step 3 - chakdeindia6076@gmail.com
chakdeindia6076@gmail.com
gnav4652 - 06-14-08 00:46
BEFORE READING GET READY WITH PEN N PAPER.NOT THE QUES OF USMLE BUT FOR SOMEONE'S LIFE N DEATH.IN ADVANCE THANX FOR THE GUIDANCE.QUES OPEN FOR ALL
A 27 YR OLD MAN WITH HISTORY OF CHRONIC ALCOHOLISM SINCE 7YRS HAS UNDERGONE FEW LAB TEST WITHOUT ANY SYNTOMS OR CHIEF COMPLAINTS.THIS ARE THE RESULTS OF JAN 2008.
GLUCOSE,BUN,CREATININE,CALCIUM,ALBUMIN,TOTAL BILIRUBIN,TOTAL PROTEIN,A/G RATIO,BUN/CREATINNE RATIO,GLOBULIN,SODIUM,POTTASIUM,CHLORIDE,CO2CT,WBC,RBC,HGB,HCTMCHC,RDW,MPV,PLATELET COUNT,LYMPHOCYTES,MONOCYTES,NEUTROPHILLS,EOSINOPHILLS,BASOPHILS..........EVERYTHING UNDER NORMAL LIMITS.
ABNORMAL DATA
MCV 97.5fl(80-94)
MCH 33.7pg(27-31)
CHOLESTEROL 253 mg/dl(100-199)
TAG'S 224mg/dl(30-149)
LDL CHOLESTEROL 152mg/dl(0-129)
HDL CHOLESTEROL 56mg/dl(40-59)
LIVER PROFILE:
ALK PHOS 127U/L(39-117)
ALT(SGPT) 83U/L(0-40)
AST(SGOT) 84U/L(0-37)
GGT 323U/L(11-50)
AFTER SEEING THIS LAB PROFILE,WHATS THE DIAGNOSIS AND TREATMENT FOR THESE PATIENT?WHAT PRECAUTIONS DOES HE NEED TO TAKE AND WHAT IF HE DOESNT GIVE UP HIS HABIT.HOW LONG CAN HE SURVIVE?
ALSO AFTER THESE ABNORMAL PROFILE HE COMPLETELY GAVE UP ALCOHOL AND WAS TAKING CENTRUM MULTIVITAMIN ONE TAB/DAY ALON WITH VIT B1 AND STILL HE IS GOING ON WITH IT, THEN THE LIVER PROFILE WAS REDONE WHICH IS AS FOLLOW:
TOTAL PROTEIN,ALBUMIN,TOTAL BILIRUBIN,DIR BILI,ALK PHOS ARE IN NORMAL LIMITS.
AST 50(0-40)
ALT 76(0-55)
SO PLZ ANSWER THE ABOVE QUESTIONS.ALSO DOES HE HAVE CHANCES THAT HE MIGHT DEVELOP SOME OR THE OTHER LIVER DISORDER AND WHAT?
gnav4652 - 06-14-08 00:46
BEFORE READING GET READY WITH PEN N PAPER.NOT THE QUES OF USMLE BUT FOR SOMEONE'S LIFE N DEATH.IN ADVANCE THANX FOR THE GUIDANCE.QUES OPEN FOR ALL
A 27 YR OLD MAN WITH HISTORY OF CHRONIC ALCOHOLISM SINCE 7YRS HAS UNDERGONE FEW LAB TEST WITHOUT ANY SYNTOMS OR CHIEF COMPLAINTS.THIS ARE THE RESULTS OF JAN 2008.
GLUCOSE,BUN,CREATININE,CALCIUM,ALBUMIN,TOTAL BILIRUBIN,TOTAL PROTEIN,A/G RATIO,BUN/CREATINNE RATIO,GLOBULIN,SODIUM,POTTASIUM,CHLORIDE,CO2CT,WBC,RBC,HGB,HCTMCHC,RDW,MPV,PLATELET COUNT,LYMPHOCYTES,MONOCYTES,NEUTROPHILLS,EOSINOPHILLS,BASOPHILS..........EVERYTHING UNDER NORMAL LIMITS.
ABNORMAL DATA
MCV 97.5fl(80-94)
MCH 33.7pg(27-31)
CHOLESTEROL 253 mg/dl(100-199)
TAG'S 224mg/dl(30-149)
LDL CHOLESTEROL 152mg/dl(0-129)
HDL CHOLESTEROL 56mg/dl(40-59)
LIVER PROFILE:
ALK PHOS 127U/L(39-117)
ALT(SGPT) 83U/L(0-40)
AST(SGOT) 84U/L(0-37)
GGT 323U/L(11-50)
AFTER SEEING THIS LAB PROFILE,WHATS THE DIAGNOSIS AND TREATMENT FOR THESE PATIENT?WHAT PRECAUTIONS DOES HE NEED TO TAKE AND WHAT IF HE DOESNT GIVE UP HIS HABIT.HOW LONG CAN HE SURVIVE?
ALSO AFTER THESE ABNORMAL PROFILE HE COMPLETELY GAVE UP ALCOHOL AND WAS TAKING CENTRUM MULTIVITAMIN ONE TAB/DAY ALON WITH VIT B1 AND STILL HE IS GOING ON WITH IT, THEN THE LIVER PROFILE WAS REDONE WHICH IS AS FOLLOW:
TOTAL PROTEIN,ALBUMIN,TOTAL BILIRUBIN,DIR BILI,ALK PHOS ARE IN NORMAL LIMITS.
AST 50(0-40)
ALT 76(0-55)
SO PLZ ANSWER THE ABOVE QUESTIONS.ALSO DOES HE HAVE CHANCES THAT HE MIGHT DEVELOP SOME OR THE OTHER LIVER DISORDER AND WHAT?
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#1
Re: chakdeindia6076@gmail.com TheOne - 06-14-08 16:49 Open for discussion!
My thinking that he has mild alcoholic hepatitis.
Precaustions: Stop drinking, avoid medications (like pain killers and NSAIDs, Anti-Depressants, etc.), Stop Smoking if he does, Avoid un-helathy food (Keep Healthy weight).
If he keeps drinking he will eventually develop Liver Cirrhosis which is fatal if not managed properly (liver transplant).
There's no big concern on his life if he sticks to what he should do (as mentioned on the precautions) and he should continue his vitamins and minrals intake daily.
#2
Re: chakdeindia6076@gmail.com radhamesramos - 06-16-08 10:33 This patient has mild alcoholic hepatitis, but he needs also to do a viral hepatitis panel to see if he also has on of the viral hepatitides...but since the descent of Transaminases after quitting, you can almost be sure that is alcoholic Hepatitis.
Do not take Acetaminophen, and beware with multivitamins, some might contain Copper and other metals which might be toxic to the liver, and redo a hepatic panel again in 2 months.
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