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A 21 year-old man with nausea, vomiting, and jaundice has the following laboratory findings:
Total serum bilirubin |
8.5 mg/dL (normal 0-1.0 mg/dL) |
Direct serum bilirubin |
6.1 mg/dL (normal 0-0.5 mg/dL) |
Urine urobilinogen |
Increased |
Urine bilirubin |
Positive |
AST |
200 U/L (normal 0-50 m/L) |
ALP |
160 U/L (normal 0-150 m/L) |
What disease state are these findings consistent with?
1) Hemolytic anemia
2) Early hepatitis
3) Chronic liver disease
4) Obstructive jaundice
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- A college student was brought to hospital with complaint of recurrent abdominal pain. He informedthe doctor that the pain increases whenever heeatsoil rich foods. Clinical examination showed yellow colored sclera. His serum total bilirubin, conjugated and unconjugated bilirubin levels were 8 mg/dL, 6 mg/dL and 2 mg/dL respectively. The urine test was positive for bilirubin. However,urobilinogen was not found in urine. WRITEand EXPLAINyour diagnosisFollowing surgery to correct a massive hemorrhage, a 55-year-old patient exhibits oliguria and edema. Blood test results indicate increasing azotemia and electrolyte imbalance. The glomerular filtration rate is 20 mL/min. Urinalysis results are as follows: COLOR: Yellow KETONES: Negative CLARITY: Cloudy BLOOD: Moderate GRAVITY: 1.010 BILIRUBIN: Negative pH: 7.0 UROBILINOGEN: Normal PROTEIN: 3+ NITRITE: Negative GLUCOSE: 2+ LEUKOCYTE: Negative Microscopic: 50–60 RBCs/hpf 2–3 granular casts/lpf 3–6 WBCs/hpf 2–3 RTE cell casts/lpf 3–4 RTE cells/hpf 0–1 waxy casts/lpf 0–1 broad granular casts/lpf What diagnosis do the patient’s history and laboratory results suggest? What is the most probable cause of the patient’s disorder? Is this considered to be of prerenal, renal, or postrenal origin?What is the patient's creatinine clearance given the following data? Serum creatinine 0.6 mg/dL Urine creatinine 102 mg/dL 24 hr urine volume 1650 mL Patient's BSA 1.93 m2 1) 195 mL/min 2) 130 mg/dL 3) 93 mL/min 4) 175 mL/min no references, just homework
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