Lab Case 80

A 51 year old man is brought to your ED by his family. He has been slightly confused and also had diarrhoea and vomiting for the last three days.

The patient drinks about 3 litres of vodka per day. He has recently been started on Desvenlafaxine for depression.

He also has some visual hallucinations

On examination he looks jaundiced.

Vitals:

BP   90/60

PR  120/min

Blood Results:

Hb  144

Platelets  141

WCC  12.4

Neutrophils   9.5

Bilirubin  94   (<21 umol/l)

ALP  227  (35-110  U/L)

GGT  1032  (<51 U/L)

ALT  161  (<56  U/L)

Albumin 33  (38-50  g/l)

TP  64  (65-85  g/l)

Na  131   (134-146  mmol/l)

K  2.8  (3.4-5.5  mmol/l)

Cl  80  (95-108  mmol/l)

HCO3  31  (22-32  mmol/l)

Urea   12.9  (3-8  mmol/l)

Creat  147  (40-120  umol/l)

CRP  60

AST  298   (<41  U/L)

Questions:

  1. Describe the blood results
  2. Interpret
  3. What examination findings would assist in your asssessment of this patient
VN:F [1.9.22_1171]
Rate this post
Rating: 5.0/5 (1 vote cast)
Lab Case 80, 5.0 out of 5 based on 1 rating

2 thoughts on “Lab Case 80

  1. alcoholic hepatitis with AST: ALT almost 2:1.
    hypokalemia hypochloremia secondary to vomiting and dehydration; likely associated metabolic all (hco3 is 31) but pH not given.
    Useful examinatins findings would be – RR, temp, features of CLD, volume status (likely dry), glucose, ketones.

    Needs RX isotonic hydration, thiamine, K replacement +/- glucose, benzos by AWS, analgesia.
    further Ix needed is Coag profile Lipase and biliary US.

    VA:F [1.9.22_1171]
    Rate this comment
    Rating: 0.0/5 (0 votes cast)
  2. use of benzo’s in patients with liver failure/ cirrhosis?

    VN:F [1.9.22_1171]
    Rate this comment
    Rating: 0.0/5 (0 votes cast)

Comments are closed.