Question

chapter 4 Gastrointestinal Disorders Case Study 46 Case Study 46 46lass/Group Date Group Members apply to this case study Your responses should be brief and to the point. When askecd o provide several answers, ist them in order of clearly If your response is not legible, It wil be marked as 7 and you will need to or wite Scenario P.M, a 24- year-eld house painter, has been tooill to work for the past 3 days. When he arrives at your out ouatient dinic, he seems an alert but acutely ill young man of average build, with a deep tan over exposed areas of skin. He reports headaches, severe myalgia, a low-grade fever, cough, anorexia, and nausea and vomiting NM, especially after eating any fatty food. P.M. describes vague abdeminal pain that started about the same time as the other problems. His past medical history (PMH) reveals he has no health prob- lems, s a nonsmoker, and drinks a "Yew beers each evening to relax. Vital signs (VS) are 128/84, 88, 26 100.6 F; awake, alert, and oriented (AAO) in his muscles; very slight scleral jaundice present; heart tones clear and without adventitious bowel sounds clear ou note moderate hepatomegaly measured at the midelavicular line; liver edge is easily palpated and tender to palpati P.M. Is manifesting the key signs of hepatitis. Lab work is sent for identification of his precise problem. Results are No 140 mmoV/L, K 3.9 mmol/L, Cl 102 mmol/L, co, 26 mmol/L, BUN 10 mg/dl, creatinine 1.0 mg/dil, platelets 86 thou/cmm, direct bilirubin 1.6 mg/dl, total billiubin 2.3 mg/dl, albumin 3.8 g/dl, total protein 6.2 g/dl, alanine aminotransferase (ALT) 66 units/L aspartate aminotransferase AST) 52 units/L, lactate dehydrogenase (LDH),205 units/L, alkaline phosphatase 176 units/L PT 12 sec, 3; moves all extremities well(MAEW) except for aching pain throughout abdomen and pelvis; abdomen soft and palpable without distinct masses. on. P.M. mentions that his urine has been getting darker over the past 2 days. INR 1.06, PTT 32 sec. Urine urobilinogen is 1.6 IU/L, albuminuria 160 mg/dl, positive for bilirubinuria, positive for anti-HAV (hepatitis A virus) IgM 1. Which key diagnostic tests will determine exactly what type of hepatitis is present? est, done Soc e Presence a or specf НА Ai 2. A CBC, BMP, LFT, and PT/PTT were drawn. Which of the lab values listed above specifically indicates liver disease?

Answer 1

2. Liver function tests are also referred to as a hepatic panel which are a group of blood tests that provide information about the state of a patient's liver.In this case study, blood have been drawn to confirm the diagnosis. The liver function panel in this case includes a) Chloride b) Prothrombin time (PT/INR), c) aPTT, d) Albumin, e) Bilirubin ( direct and total), f) Total proteins, g) the liver transaminases such as Aspartate transaminase (AST or SGOT), Alanine transaminase (ALT or SGPT), Alkaline phosphatase (ALP) h) Urobilinogen i) Bilirubinuria and j) Anti- HAV (hepatitis A) IgM.

3. Medications that can cause an increase in liver enzyme called ALT are a) Aspirin b) Acetaminophen and c) Ibuprofen.

4. Hepatocyte means it is a cell of the main parenchymal tissue of the liver makes up to 70-85 percentage of mass in the liver. The main function of these cells are protein synthesis and protein storage. Foods that I recommend for P.M is:

a) Eat a balanced diet: meaning includes foods from all groups such as grains, fruits, vegetables, meat and beans, ilk and oil

b) Eat food rich in fiber c) Drink plenty of water to prevent dehydration and makes liver to function better e) Avoid alcohol f) Do not eat foods high in sugar, fat and salt.

5. Hepatitis (hepa- liver, itis- inflammation) means inflammation of the liver.

Hepatitis A virus : It is a viral liver disease that can cause acute inflammation in the liver. It is easily spread from one person to another through contaminated food and water or through direct contact with an infectious person and can infect many people at once. Safe water supply, food safety, improved sanitation, hand washing and Hepatitis A vaccine are the most effective ways to combat this disease.

Heptitis B virus: can be both acute ( short-term) and chronic (long-term) illnesses. It can spread through blood or other body fluids in various ways such as during birth, sex with an infected person, sharing needles or syringes, sharing tooth brushes or razors and through direct contact. the best way to overcome this disease is vaccination. It stimulates the natural immune system to protect against the hepatitis B virus. After the vaccine, the body makes antibodies to protect against the virus.

Hepatitis C virus: This virus is almost always chronic and spread only through blood. Parenteral exposure through blood or blood product is the main cause of the disease in majority of cases along with this, intravenous drug users are also prone to get infection through repeated exposure to contaminated injection equipment. There is no vaccination for hepatitis C virus but one can save themselves from the infection by safe practices. For instance., not sharing of needles, avoiding body tattooing and safe handling of blood and blood products.