Question

A 55 year old man visited his physician because he noticed abdominal swelling and complained of fatigue and weakness. Upon physical examination, the physician noted icteric (jaundice) sclera, some edema around the ankles, splenomegaly and hepatomegaly. He also admitted to drinking at least 5 martinis every night and more on weekends for a number of years.

His chemistry results:

Total Bilirubin	2.5	High
Direct Bilirubin	1.51	High
AST	350	High
ALP	214	High
ALT	200	High
Albumin	3.0	Low
GGT	300	High
Total protein	7.2	Normal
Cholesterol	160	Normal
Coagulation PT	16	High

Serology Results:

Anti-HCV	Nonreactive	Normal
Anti-HAV (IgM)	Nonreactive	Normal
Anti-HAV (total)	Nonreactive	Normal
Anti-HBsAg	Nonreactive	Normal
Anti-HBcAg	Nonreactive	Normal

1. What organ is involved? What is condition is this?

2. What is the pathology changes of the organ in this condition?

3. What etiology is the most probable cause of this disease?

4. Why is the PT prolonged and the albumin decreased?

Answer 1

Question

1. The liver is involved here in this question. This condition is infection in the liver or could be hepatocellular injury or cirrhosis.

2. The pathology of the disease include accumulation of too much bilurubin in the liver that cause severe liver infection.

3. The etiology of the disease include drinking of excessive alcohol that lead to the buildup of bilurubin , a waste material in the liver and autoimmune disorder.

4. The albumin is the protein produced by the liver and is decreased beacuse of the inflammatory disease in the liver. PT is high because liver is no longer able to make correct amount of blood clotting proteins due to serious liver damage .