04-12-2007, 10:42 AM
A 47yo female comes to the ER because of severe abdominal pain for 3 hours. The pain began after a 2-week drinking binge. She has a 15-year history of alcoholism. She has no history of jaundice or hepatitis. Current medications include multivitamins and iron. Her temperature is 38�C (100.4�F), blood pressure is 110/80 mm Hg, and pulse is 110/min. Examination shows mild jaundice and diffuse spider angiomata over the trunk and abdomen. The liver is tender to palpation. A complete blood count shows mild anemia with normal red cell indices. Ultrasonography of the abdomen shows normal-sized hepatic ducts. Which of the following is the most likely set of laboratory findings?
Total Indirect Alkaline Alanine
Bilirubin Bilirubin Phosphatase Aminotransferase Reticulocyte
(mg/dL) (mg/dL) (U/L) (ALT, GPT) (U/L) Count (%)
A)2 0.9 80 30 1.2
B)3 2.8 70 30 1.0
C)3 2.8 80 20 3.0
D)4 2.0 800 200 1.5
E)4 1.0 150 400 1.0
Total Indirect Alkaline Alanine
Bilirubin Bilirubin Phosphatase Aminotransferase Reticulocyte
(mg/dL) (mg/dL) (U/L) (ALT, GPT) (U/L) Count (%)
A)2 0.9 80 30 1.2
B)3 2.8 70 30 1.0
C)3 2.8 80 20 3.0
D)4 2.0 800 200 1.5
E)4 1.0 150 400 1.0