]> 2026-07-31T07:51:09+00:00 WBR0624 0 en Alcoholic hepatitis Primary sclerosing cholangitis '''Incorrect''' : Primary sclerosing cholangitis (PSC) is usually a progressive disorder that ultimately leads to complications of cholestasis and hepatic failure with underlying ulcerative colitis. Liver biochemical tests usually demonstrate a cholestatic pattern, with elevation of the serum alkaline phosphatase predominating in most patients. The serum aminotransferases are typically less than 300 IU/L. The serum alkaline phosphatase and bilirubin may fluctuate substantially, possibly indicating transient blockage of strictured bile ducts by biliary sludge or small stones. Viral hepatitis Primary biliary cirrhosis '''Incorrect''' : Primary biliary cirrhosis (PBC) is characterized by a T-lymphocyte-mediated attack on small intralobular bile ducts. The signs and symptoms of PBC usually include pruritus, hyperpigmentation of the skin, and hepatomegaly in a woman with serum alkaline phosphatase concentration is almost always elevated, often to striking levels. Serum levels of 5'-nucleotidase and gammaglutamyl transpeptidase parallel those of alkaline phosphatase. The serum levels of aminotransferases may be normal or slightly elevated and antimitochondrial antibodies are the serologic hallmark of PBC. Autoimmune hepatitis '''Correct''' : Autoimmune hepatitis is characterized by elevated AST and ALT with normal bilirubin and ALP levels. Patients are associated with other autoimmune conditions like ulcerative colitis as in this patient. Primary Care Office A 34 year old Caucasian female, comes to the office with complaints of fatigue, lethargy, malaise, anorexia, nausea and abdominal pain for the past few weeks. She has been having fever on and off and an increase in the frequency of stools of 4-5 times a day over the past month with a single episode of blood in stools. Her past history is insignificant and her family history is unremarkable. She has no recent travel exposure outside the country. She denies smoking and drugs, but consumes alcohol occasionally. Her menstrual cycles are normal. Her temperature is 36.7 C, blood pressure is 130/70 mmHg, pulse is 102/min and respirations are 16/min. The physical examination is normal except for mild abdominal pain on the right upper quadrant and epigastric area. Serum biochemistry results shows Na:135 mEq/L, K: 3 mEq/L, Cl:104mEq/L, Bi: 24 mEq/L, BUN: 30 mg/dl, glucose:226 mg/dl, Mg:1mg/dl and Ca: 8mg/dl. The liver fuction test results are as follows: Alanine aminotransferase : 110 U/L Aspartate aminotransferase : 100 U/L Alkaline phosphatase : 130 U/L Total bilirubin : 1.3 mg/dl Direct bilirubin : 1.3 mg/dl Hepatits A IgM : negative HbsAg : negative HBc Antibody : negative HCV Antibody : negative What is the most likely diagnosis in this patient ? E Gastrointestinal 2020-10-28T01:12:55Z 2459150.5506366 WBR0624