A 49-year-old male schoolteacher presents with nausea and fatigability. He has right upper quadrant abdominal pain for 10 days duration. He has right chronic frozen shoulder and rotator cuff tendonitis. He takes pain medications regularly. He is found to be jaundiced as well. His initial laboratory findings are as follows: ALT 1680 U/L (normal range 7-55 U/L) AST 1988 U/L (normal range 8-48 U/L) Alkaline phosphatase 720 U/L (normal range 45-115 U/L) GGT 377 U/L (normal range 9-48 U/L) Which of the following represents the most likely etiology for this extreme elevation in liver enzymes?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: B. Acetaminophen intoxication.
AST/ALT in the thousands indicate severe acute hepatocellular injury, and the first cause to check in such a patient is acetaminophen (Tylenol) toxicity. This man takes painkillers regularly for chronic shoulder pain, making paracetamol hepatotoxicity the most likely cause. Chronic hepatitis C causes only mild-moderate enzyme rises, and metastatic disease or acalculous cholecystitis would give a cholestatic/mild pattern rather than transaminases near 2000.
- المصدر
- 6• Acute Liver Failure [Notes].pdf · p. 3
6• Acute Liver Failure [Slides].pdf · p. 2 - المحاضرة
- Acute Liver Injury & Failure · Gastroenterology & Liver · Module C
- ظهر في
- GI bank