A 50 year old female presents with epigastric and RUQ pain, nausea and arthralgias of 2 days duration.

Vitals:

BP 120/80

PR  80/min

RR  16/min

Her blood results are as follows:

Hb    135    g/l    (115-135)

Platelets   293     (140-400)

WCC    50.1    (4-11)

N   17.3          (1.8-7.5)

L    31.1          (1-4)

Bilirubin     61     (<16   umol/l)

ALP       236      (20-105 U/L)

GGT       513      (<36  U/L)

ALT       252       (<31  U/L)

Albumin     47    (38-50)

Lipase      4233    (13-60  IU/L)

Questions:

1. Describe three key abnormalities

2. List the causes of her haematologic derangement

3. What specific clinical features would inidicate the need for urgent haematology review?