USMLE Forum Archives - USMLE Step 2 CK - Sudden change!!!
Sudden change!!!
laparotomy - 01-06-08 14:23
A 62 year old male presents with constipation for 3 days and mild to moderate abdominal discomfort. His past history is significant for a triple bypass operation 5 years ago. His lab values are normal. An overly cautious surgical resident admits the patient. The next day he becomes confused. Urgent bloods are taken with the following results: ALT 1100, Bilirubin 5, Creatinine 7, BUN 72.
What is your diagnosis?
laparotomy - 01-06-08 14:23
A 62 year old male presents with constipation for 3 days and mild to moderate abdominal discomfort. His past history is significant for a triple bypass operation 5 years ago. His lab values are normal. An overly cautious surgical resident admits the patient. The next day he becomes confused. Urgent bloods are taken with the following results: ALT 1100, Bilirubin 5, Creatinine 7, BUN 72.
What is your diagnosis?
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#3
Re: Sudden change!!!
laparotomy - 01-07-08 14:43 Obviously it is a hepatorenal failure, but what is the cause?
#5
Re: Sudden change!!! zeemoon5 - 01-08-08 08:33 not enough in case. Does it has to do with the triple bypass...
#6
Re: Sudden change!!! laparotomy - 01-08-08 11:01 That is some serious constipation if it caused a hepatorenal failure...
Okay I will give you the options
A.Dehydration causing prerenal failure
B.Ascending Cholangitis
C.Fulminant viral hepatitis
D. Ischemic hepatitis
E. Drug induced hepatitis
#8
Re: Sudden change!!! TheOne - 01-08-08 15:35 D. Ischemic hepatitis
I think i understood the question in a wrong way, constipation should be avoided in patients with critical hepatic function cause it may lead to hepatic encephalopathy, right?
#10
Re: Sudden change!!! laparotomy - 01-14-08 05:09 Exactly the one that is why lactulose is a treatment to of hepatic encephalopathy and also prophilactic to prevent it...
#11
Re: Sudden change!!! laparotomy - 01-14-08 05:10 Anyway the answer is ischemic hepatitis.... congrats to those that got it right.
#12
Re: Sudden change!!! ammulufy - 07-03-10 20:52 Bcos he developed dose symptoms after being admitted to d hospital....probably its drug induced hepatitis,i.e d.
#13
Re: Sudden change!!! babbu5508 - 07-07-10 21:31 Urgent bloods are taken with the following results: ALT 1100, Bilirubin 5, Creatinine 7, BUN 72.....hepatorenal syndrome
#14
Re: Sudden change!!! bingousmle - 07-12-10 05:32 constipation leading to hepatic encephalopathy.. though the patient should have pre existing decompensated hepatic failure which is not mentioned
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