Case Presentation, Part I
b. Lab Results
After examining Mrs. Nguyen, you find sclera icterus and slight hepatosplenomegaly. You then order some lab tests, the results of which show elevated liver function tests as seen below.
Results of liver function tests (LFT), electrolytes |
Test |
Normal Range |
ALBUMIN |
4.3 G/DL |
3.5-4.8 |
BILIRUBIN, TOTAL |
[H] 5.7 MG/DL |
0.3-1.2 |
BILIRUBIN, DIRECT |
[H] 4.3 MG/DL |
0-0.4 |
ALKALINE PHOSPHATASE, TOTAL |
[H] 146 U/L |
25-100 |
PROTEIN, TOTAL |
7.0 G/DL |
6.0-8.2 |
ALT(SGPT) |
[H] 435 U/L |
5-31 |
AST(SGOT) |
[H] 176 U/L |
5-40 |
AMYLASE |
39 U/L |
20-104 |
LIPASE |
34 U/L |
16-63 |
INR is 5.8 (normal range of patients on warfarin is 2.0-3.0).
In the office, a finger stick glucose test reads 52 mg/dL
Please answer the following questions in the space provided (approximately 5-10 mins).
In discussing the case, there are several problems to address. What do you think is happening? List two reasons why you suspect Ms. Nguyen is having symptoms.
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