Liver Disease

Liver Disease Treatment Plans

100

A 29 year-old female with history of hypothyroidism at 15 weeks of gestational age comes to the clinic with a 5-day history of general malaise, nausea, vomiting and itching. She has noticed darker looking urine. exam: She is jaundiced, looks ill. There is mild discomfort in palpation of the right upper quadrant. Labs: AST 620 ALT 723 T. Bili 5.3 D. bili 2.8 Alk Phos 321 Alb 3.1. What is the likely cause of her elevated liver tests? Intrahepatic cholestasis of pregnancy Autoimmune hepatitis Choledocholithiasis Hypermesis gravidarum Viral hepatitis

What is Viral hepatitis

200

You are seeing a 43 year old woman with NASH (NAFLD), her risk factors include hypertension for which she is non-compliant with medications, diabetes (HGBA1C 11.0) and obesity. She is complaining of chronic fatigue, mood alterations and says she is having a difficult time sleeping. She is requesting medications to make her feel better, what would you tell her knowing there are no FDA-approved therapies for the treatment of NAFLD? Lifestyle modifications (eating habits, weight loss, medication compliance) Prescribe a sleep study for potential sleep apnea Frequent monitoring of labs (HDL, LDL, Tryglyceride levels, CBC, HGBA1C) Increase vitamin E All of the above

What is All of the above

300

Total parenteral nutrition is often complicated by cholestatic hepatitis attributable to steatosis, cholestasis, or gallstones. What is one of the first interventions of recourse in prevention of abnormal liver function related to TPN administration? Balancing the TPN formula with more lipids Completely stop TPN Cholecystectomy Actigall 300mg/ daily

What is Balancing the TPN formula with more lipids

400

A patient with known cirrhosis has been admitted to the hospital for a urinary tract infection and dehydration. Upon arrival they are found to be hypokalemic and hyponatremic. The patient’s family has stated the patient has become more aggressive and confused. One of the differential diagnosis includes hepatic encephalopathy. Treatment for hepatic encephalopathy includes all of the following EXCEPT: Hydration and correction of the electrolyte imbalance Lactulose BID Tetracycline Rifaximin 550 mg BID

What is Tetracycline

500

.An 25 year old female patient presents to the emergency room complaining of severe abdominal pain, nausea, vomiting and diarrhea that began around 4 hours prior. The patient states she was having back pain earlier in the evening and took a “handful of Tylenol” to help relieve the pain and an over the counter sleep aid to help her try and sleep. Labs: Hgb 12.5 WBC 8.7 platelets 149,000 INR 2.2. AST 6232 U/L ALT 9212 U/L, bilirubin 4.9 mg/dl, creatinine 3.1 mg/dl. Acetaminophen 300 mcg/mL. Which of the following would you recommend now? Start lactulose therapy. Start treatment with D-penicillamine Intravenous steroids Intravenous N-acetylcysteine Intravenous Acyclovir.

What is Intravenous N-acetylcysteine