Question

Patient: 25-year-old female History: had used heroin 2x, borrowed roommates needle 2 months earlier Symptoms: cough, nausea, vomiting, fever, pelvic tenderness, temp inc, pulse inc, blood pressure dec, liver palpable Tests Reference Range Value On admission: On 8th day: comatose 204 66 Total Bilirubin Alkaline Phosphatase AST ALT Amylase 782 300 1420 850 5320 1460 610 3 - 20 umol/L 30 - 128 U/L 0-40 U/L 0-45 U/L 0 - 45 U/L Na 133 3.2 135-145 mmol/L 3.5 - 5 mmol/L 24-32 mmol/L HCO3 ДА 4 - 11 x10°/L WBC PT 15 20 (12) 38.5 ammonia creatinine 114 168 906 11-35 umol/L 40 - 110 umol/L HBsAg positive negative 1. What is the likely diagnosis? Explain. 2. Explain the increased PT. 3. Explain the increase in enzymes. 4. What does the increase in amylase signify?

Answer 1

Q.1:

Diagnosis: Hepatitis B

Explain:

1. Positive hbsag indicates hepatitis B

2. This may occur due to sharing of contaminated needles, patient had history for that.

3. Elevated birubin, ALT, AST also indicates liver damage.

Q.2

1. Increased PT level indicates Acute liver damage.

2. Here the patient is having prolong PT level.

Q.3

1. Elevated alkaline phosphatase indicates the liver damage.

2. Elevated ALT, AST also indicates the liver damage.

3. Bilirubin level also raised in liver damage.

Q.4

1. This elevated amylase level indicates its associated with pancreatitis.