new_n_lost
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A 28-year-old lady develops abdominal pain, jaundice and ascites worsening over a week. She drinks ten units of alcohol each week and takes the oral contraceptive pill.
Which of the following findings would make a diagnosis of hepatic vein thrombosis (Budd-Chiari syndrome) MOST likely?
1) Alanine aminotransferase of 345 U/L (5 - 35)
2) Acute liver failure
3) Ankle edema
4) Ascites fluid protein of 38 g/L
5) Tender enlarged liver
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| Aashi
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4) Ascites fluid protein of 38 g/L
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| new_n_lost
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The most common causes of an acute severe liver injury in a young woman are:
viruses (including: HAV, HBV),
drugs (particularly paracetamol OD),
Autoimmune hepatitis,
Hepatic vein thrombosis (often precipitated by pregnancy or OCP use).
The presence of liver failure, ankle oedema, and an exudative ascites do not help differentiate between these aetiologies.
The ALT of 345 is moderately elevated and compatible with BCS.
With viral or drug related hepatitis the peak ALT is usually much higher than this, the ALT may already be on the way down if she has had symptoms for a week.
Tender hepatomegaly is one of the hallmarks of BCS.
In acute severe viral, autoimmune or drug / toxin related liver disease the necrotic liver decreases in size.
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| jole
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The ALT of 345 is moderately elevated and compatible with BCS
Tender hepatomegaly is one of the hallmarks of BCS.
so which one is the MOST likely??thanks
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| new_n_lost
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5) Tender enlarged liver
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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