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رجوع لأسئلة Cirrhosis & Complications 4 / 7
C-210 مطابق للمصدر تكرر ×2

A 54-year-old woman had fatigue for 8 months and dark urine which noticed 6 weeks ago. Positive physical examination findings include scleral icterus, multiple spider telangiectasias over the chest and back, a liver edge palpated 4 cm below the right costal margin, and an enlarged spleen palpated 6 cm below the left costal margin. Results of complete blood count as well as measurement of serum electrolytes, urea nitrogen, and creatinine are normal. Other laboratory tests show: Alanine aminotransferase 78 U/L (10 - 40) Aspartate aminotransferase 680 U/L (10 - 30) Serum bilirubin 20.8 mg /dl (0.3 - 1.2) Direct bilirubin 8.7 mg/dl (0 - 0.2) Alkaline phosphatase 145 U/L (25 - 100) Serum albumin 2.8 g/dl (3.4 - 4.8) Serum protein 8.7 g/dl (6.4 - 8.3) Prothrombin time 12 sec (18 - 22) Which of the following diagnostic studies should be performed next?

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الإجابة: C. Blood work for causes of Cirrhosis

✓ مطابق للمصدر Cirrhosis -.pdf · p. 3

Spider telangiectasias, hepatosplenomegaly (portal hypertension), low albumin and high globulin point to established cirrhosis, so the next step is to find its cause with targeted blood work: viral serology (HBsAg, anti-HBc, anti-HCV), iron studies, autoimmune markers (ANA, ASMA, IgG), ceruloplasmin/copper, alpha-1 antitrypsin, AMA. ALP is only mildly raised, so there is no obstructive picture to justify ERCP, and a HIDA scan is for acute cholecystitis. Cross-sectional MRI is not the next step; ultrasound/CT are the imaging tests used for cirrhosis.

المصدر
Cirrhosis -.pdf · p. 3
المحاضرة
Cirrhosis & Complications · Gastroenterology & Liver · Module C
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