USMLE Forum Archives - USMLE Step 2 CK - jaundice
jaundice
bingousmle - 05-19-10 10:17
A 66-year-old woman who has previously been healthy undergoes emergency surgery for a ruptured abdominal aortic aneurysm. Intraoperatively she requires 8 units of packed red blood cells to maintain her blood pressure and hematocrit. After surgery she is hemodynamically stable. On the third postoperative day she appears jaundiced, but abdominal examination is unremarkable and she is afebrile. Total serum bilirubin concentration at this time is 141 mol/L (8.3 mg/dL) [direct, 107 mol/L (6.3 mg/dL)]. Serum alkaline phosphatase level is 6 kat/L (360 U/L), and serum AST level is 0.85 kat/L (51 Karmen units/mL). The most likely explanation for the woman's jaundice is
A: a stone in the common bile duct
B: halothane hepatitis
C: posttransfusion hepatitis
D: acute hepatic infarct
E: benign intrahepatic cholestasis
bingousmle - 05-19-10 10:17
A 66-year-old woman who has previously been healthy undergoes emergency surgery for a ruptured abdominal aortic aneurysm. Intraoperatively she requires 8 units of packed red blood cells to maintain her blood pressure and hematocrit. After surgery she is hemodynamically stable. On the third postoperative day she appears jaundiced, but abdominal examination is unremarkable and she is afebrile. Total serum bilirubin concentration at this time is 141 mol/L (8.3 mg/dL) [direct, 107 mol/L (6.3 mg/dL)]. Serum alkaline phosphatase level is 6 kat/L (360 U/L), and serum AST level is 0.85 kat/L (51 Karmen units/mL). The most likely explanation for the woman's jaundice is
A: a stone in the common bile duct
B: halothane hepatitis
C: posttransfusion hepatitis
D: acute hepatic infarct
E: benign intrahepatic cholestasis
The correct answer and explanation will be available after you answer.
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#2
Re: jaundice babbu5508 - 05-19-10 13:41 My answer is: b.
acute severe hepatitis with potential development of hepatic necrosis and acute liver failure, which is often fatal [34,41]. The incidence is 1 in 6000 to 1 in 35000 following a single exposure to the anesthetic and increases to about 1 in 3000 following multiple exposures .Other risk factors for severe hepatotoxicity may include short intervals between exposures, female gender, age greater than 50, obesity, and a genetic predisposition to hepatitis
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