Question

May you please Justify your answer to this question. what do you think? what is your diagnosis for the patient? Please provide a complete response answer.

After 4 years of Medical school, you start your Internal Medicine residency at Princeton- Plainsboro Teaching Hospital (PPTH) under the guidance of Dr. Gregory House. Dr. House arrives and said Woman, 33 years old,is in ER and she refers epigastric pain with nauseas, postprandial Cam- vomiting and asthenia. Two weeks ago an antibiotic for odynophagia (erythromycin) was prescribed, however she left the treatment after 9 days She does not have fever although she describes dystermia symptoms. Initial physical examination of the patient indicated a soft, depressible abdomen with epigastric and right hypochondrium pain on palpation. Mucocutaneous jaundice. No family history of liver diseases She suffered anxious syndrome and bulimia during childhood. No drug or other prescription medicine. ER performed an abdominal ultrasound, suggested acute cholecystitis with slightly enlarged liver. Based on these findings, ER carried out an open cholecystectomy and direct cholangiogram. It didn't show any alterations. Anatomopathological examination reported cholestasis and chronic liver disease pre- cirrhosis. The results of laboratory tests (blood are urine):

Answer 1

• patient diagnosis was auto immune hepatitis .according to the patient signs and symptoms and lab values obtained.
• why because based on medical history ,a physical exam and tests. patient having epigastric pain nausea and vomiting .through palpitation pain at hypochondrium and epigastric.
• patient blood and urine values shows low platelet count, high cu serum value, corelated with PT,ALT,AST.
• increased levels of AST and ALT because these liver enzymes are highly elevated in people with autoimmune hepatitis
• Auto immune hepatitis is a chronic disease in which your body 's immune system attacks the liver causes inflammation and liver damage . when it get worse it leads to the cirrhosis.
• use a liver biopsy to look for the features of autoimmune hepatitis and to check for cirrhosis.
• treatment will be with medicines that suppress your immune system, most often corticosteroids-prednisone or prednisolone -with or with out azathioprine.
• nutrition plays an important role in causing or preventing autoimmune hepatitis.