• Card 30 / 34: Which of the following most likely explains the patients liver function tests?A 35 year man is admitted to the ICU obtunded. He was found by family members on the floor of his apartment unconscious. An abdominal ultrasound is normal. The ALT is 11,000 and the AST is 8,050. The total bilirubin and alkaline phophatase are normal. Hepatitis A IgM is negative. Hepatitis B core IgM is negative. Hepatitis C antibody and Hepatitis C RNA levels are undetectable. Ceruloplasmin is normal.
    01.) Bile duct obstruction
    02.) Acute alcoholic hepatitis
    03.) Acute acetaminophen overdose
    04.) Acute hepatitis A
    05.) Acute hepatitis B
    06.) Acute hepatitis C
    07.) Alpha-1-antitrypsin deficiency
    08.) Primary biliary cirrhosis
    09.) Hemochromatosis
    10.) Wilson’s disease
    11.) Acute hepatitis E
    12.) Autoimmune hepatitis

    Answer:
    03.) Acute acetaminophen overdose

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Explanation:

Given negative viral studies, acetaminophen overdose is most likely. Autoimmune hepatitis would be other possibility but this is more common in women.

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Attribution:  Laurence Scott Bailen, Tamsin Knox, Paul Abourjaily, Fredric D. Gordon,Marshall Kaplan,Andrew G. Plaut. PPY 222 Gastrointestinal Pathophysiology, Spring 2007. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/47 (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA
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