12-15-2008, 06:03 PM
11.) A previously healthy 32-year-old man comes to the emergency
department because of a 12-hour history of fatigue and shortness of breath
at rest. He takes no medications. His temperature is 7 C (98.6 F), blood pressure is
96/58 mm Hg, pulse is 110/min, and respirations are 22/min. Examination shows
scleral icterus and conjunctival pallor. There is no hepatosplenomegaly. Laboratory
Studies show:
Hemoglobin 6.2 g/dL
Serum Leukocyte count 8800/mm3
Bilirubin, total 8.5 mg/dL
Reticulocyte count 16%
Direct 1.5 mg/dL
Platelet count 245,000/mm3
Lactate dehydrogenase 1260 U/L
A) Acute toxic hepatitis
B) Alcoholic hepatitis
C) Cholangiocarcinoma
D) Chronic idiopathic cirrhosis
E) Common bile duct calculus
F) Congestive hepatitis
G) Gallstone pancreatitis
H) Gilbert's syndrome
I) Infectious hepatitis
J) Intravascular hemolysis
K) Primary biliary cirrhosis
12.) A 24-year-old third-year medical student comes to the student health clinic for
evaluation of jaundice which he noticed this morning. He has had no abdominal
pain, itching, or weight change. He takes no medications. He describes recent
anxiety over anticipation of the upcoming Step 2 examination. His temperature is
37 C (98.6 F), blood pressure is 120/80 mm Hg, pulse is 76/min, and respirations
are 12/min. Examination shows no abnormalities except for scleral icterus.
Laboratory studies show:
Hemoglobin 15 g/dL Serum
Leukocyte count 7000/mm3
Alkaline phosphatase 90U/L
Platelet count 240,000/mm3
Aspartate aminotransferase Serum (AST, GOT) 23 U/L
Bilirubin, total 3.5 mg/dL
Alanine aminotransferase Direct 0.7 mg/dL (ALT, GPT) 27 U/L
A) Acute toxic hepatitis
B) Alcoholic hepatitis
C) Cholangiocarcinoma
D) Chronic idiopathic cirrhosis
E) Common bile duct calculus
F) Congestive hepatitis
G) Gallstone pancreatitis
H) Gilbert's syndrome
I) Infectious hepatitis
J) Intravascular hemolysis
K) Primary biliary cirrhosis
department because of a 12-hour history of fatigue and shortness of breath
at rest. He takes no medications. His temperature is 7 C (98.6 F), blood pressure is
96/58 mm Hg, pulse is 110/min, and respirations are 22/min. Examination shows
scleral icterus and conjunctival pallor. There is no hepatosplenomegaly. Laboratory
Studies show:
Hemoglobin 6.2 g/dL
Serum Leukocyte count 8800/mm3
Bilirubin, total 8.5 mg/dL
Reticulocyte count 16%
Direct 1.5 mg/dL
Platelet count 245,000/mm3
Lactate dehydrogenase 1260 U/L
A) Acute toxic hepatitis
B) Alcoholic hepatitis
C) Cholangiocarcinoma
D) Chronic idiopathic cirrhosis
E) Common bile duct calculus
F) Congestive hepatitis
G) Gallstone pancreatitis
H) Gilbert's syndrome
I) Infectious hepatitis
J) Intravascular hemolysis
K) Primary biliary cirrhosis
12.) A 24-year-old third-year medical student comes to the student health clinic for
evaluation of jaundice which he noticed this morning. He has had no abdominal
pain, itching, or weight change. He takes no medications. He describes recent
anxiety over anticipation of the upcoming Step 2 examination. His temperature is
37 C (98.6 F), blood pressure is 120/80 mm Hg, pulse is 76/min, and respirations
are 12/min. Examination shows no abnormalities except for scleral icterus.
Laboratory studies show:
Hemoglobin 15 g/dL Serum
Leukocyte count 7000/mm3
Alkaline phosphatase 90U/L
Platelet count 240,000/mm3
Aspartate aminotransferase Serum (AST, GOT) 23 U/L
Bilirubin, total 3.5 mg/dL
Alanine aminotransferase Direct 0.7 mg/dL (ALT, GPT) 27 U/L
A) Acute toxic hepatitis
B) Alcoholic hepatitis
C) Cholangiocarcinoma
D) Chronic idiopathic cirrhosis
E) Common bile duct calculus
F) Congestive hepatitis
G) Gallstone pancreatitis
H) Gilbert's syndrome
I) Infectious hepatitis
J) Intravascular hemolysis
K) Primary biliary cirrhosis
