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Author: Laurence Scott Bailen, M.D.

1. Which of the following most likely explains the patients liver function tests?

1.1. Question 1

A 55 year old man is jaundiced. His total bilirubin is 8.4 mg/dl and his ALT is 125, AST is 205, alkaline phosphatase is normal. An abdominal ultrasound is normal.

1.2. Question 2

A 60 year old woman has pruritus (itchiness). Her alkaline phosphatase is 450. Total bilirubin, ALT, and AST are normal.

1.3. Question 3

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.

Choose the correct answer from the following list:

  1. Bile duct obstruction

  2. Acute alcoholic hepatitis

  3. Acute acetaminophen overdose

  4. Acute hepatitis A

  5. Acute hepatitis B

  6. Acute hepatitis C

  7. Alpha-1-antitrypsin deficiency

  8. Primary biliary cirrhosis

  9. Hemochromatosis

  10. Wilson’s disease

  11. Acute hepatitis E

  12. Autoimmune hepatitis