 |  NBME , Think with me plz My test in week
|
 
|
| Author | 11 Posts |
dr_jojo
|
A 42-year-old woman comes to the physician for an annual pelvic examination and Pap smear. Over the past year, she has had increasing fatigue and difficulty sleeping. She has two children who both attend college. She is currently looking for part-time work outside the home. Her husband has been busy in a new start-up business. Examination shows no abnormalities. Laboratory studies show:
Hemoglobin 15 g/dL
Mean corpuscular volume 95 μm3
Leukocyte count 6000/mm3 with a normal differential
Serum
Na+ 145 mEq/L
Cl– 102 mEq/L
K+ 4.5 mEq/L
HCO3– 25 mEq/L
Urea nitrogen (BUN) 18 mg/dL
Creatinine 1.0 mg/dL
Alkaline phosphatase 70 U/L
Aspartate aminotransferase
(AST, GOT) 22 U/L
Alanine aminotransferase
(ALT, GPT) 19 U/L
γ-Glutamyltransferase
(GGT) 83 U/L
(N=5–50 U/L)
Which of the following is the most likely explanation for this patient's laboratory abnormalities?
A
) Acetaminophen
B
) Alcohol
C
) Diphenhydramine
D
) Estrogen effect
E
) Ibuprofen
|
| dr_jojo
|
GGT , ALK PHO are elevated but normal transaminases !!!
|
| huyniid
Forum Elite
Topics: 9
Posts: 199
|
B. she drinks alcohol ! that causes isolated gamma GT elevation
|
| chemamr
Forum Hero
Topics: 703
Posts: 4,462
|
elevated GGT alone can be one of the initial findings in alcoholics
it could be
___________________
Any time something is written against me, I not only share the sentiment but feel I could do the job far better myself.
|
| dr_jojo
|
but the transaminases r not elevated
|
| NE
Forum Guru
Topics: 53
Posts: 504
|
The AST and ALT could be or could be not increase in alcoholics! If there is not cellular destruction AST /ALT are normal.
GGT can be used to screen for chronic alcohol abuse (it will be elevated in about 75% of chronic drinkers).
|
| Aashi
Forum Moderator
Topics: 113
Posts: 1,061
|
Not required Jojo... occasional intake of alcohol can give u isolated elevations in GGT, its only when the liver cells gets considerably damaged u end up get elevations in the transminases, and this is usually seen with heavy drinking..
Relax jojo,I can see that you r stressed, which is quite normal at this time,but keep ur cool and dont allow the stress to take a toll ,coz this can have devastating effects during the exam..so be positive and be confident..Inshallah you will do well..
GL
___________________
"Obstacles are those frightful things you see when you take your EYES off your goal."
|
| 92306
Forum Senior
Topics: 14
Posts: 126
|
B) Alcohol
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,123
|
B, alcohol
GGT increased, always think Alcohol first unless have other clear evidence
___________________
The Key to Succeed is Patience.
|
| dr_jojo
|
thanx all ,
ya that is true this final days i am so stressed
but plz be with me all when i need an answer for any qs 
|
| dr in trouble
Forum Guru
Topics: 62
Posts: 607
|
Itz B d/t alcohol intake.
___________________
If u want to do something, do it today as there is no tomorrow.
|
|
| |
| | | | | | | | | | | |
You don't have permission to post.
|
