Liver & GIT
A 50 year old lady presented with history of painupper abdomen, nausea, and decreased appetite for 5 days. She had undergone cholecystectomy 2 years back. Her bilirubin was 10 mg/dl, SGPT 900 IU/L SGOT 700 IU/L and serum alkaline phosphatase was 280 IU/L. What is the most likely diagnosis - (AIIMS Nov 05)
|C||Acute viral hepatitis|
|D||Posterior penetration of peptic ulcer|
1. Anorexia, nausea, vomiting, fatigue, jaundice, myalgia, headache, photophobia, pharyngitis, cough, coryza.
2. Serum sickness like syndrome occur in hepatitis B leading to urticarial rash, angioedema, high grade fever and arthritis.
3. Pain Right upper abdomen due to enlargement of liver.
4. Splenomegaly and cervical lymphadenopathy are seen in upto 20% cases.
5. Spider angioma appear during icteric phase and disappear during convalescence.
1. ALT and AST rise, both > 500 IU/L, ALT > AST, ALP but < 3 times of normal - (normal ALP 30– 120 IU/L)
2. Serum bilirubin rise, and jaundice is usually visible in the sclera when serum bilirubin level are > 2.5 mg/dl.
3. Prolonged PT is associated with poor prognosis. Q
4. Hypoglycemia due to nausea, vomiting, inadequate intake and poor hepatic glycogen reserves.
5. Microscopic hematuria and proteinuria especially in hepatitis B. Q
6. Elevation of gamma globulin. IgM level is elevated more characteristically during acute hepatis A. Q
7. False positive RA factor and ANA.
8. Antibodies to liver kidney microsomes (LKM) in hepatitis C and D. Q