Please progress in order:IntroductionPre-Test Case 1: Mrs. ParkerCase 2: Mrs. NguyenLearning ObjectivesCase Presentation, Part ICase Presentation, Part IIResearching Dietary Supplement IngredientsSafety Profiles for Dietary SupplementsDocumentationConcluding RemarksCase 3: Mr. GomezCase 4: Mr. WatsonPost-Test

Case 2: Mrs. Nguyen

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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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Copyright 2011 Department of Family Medicine at Boston University School of Medicine.