Liver Disease Diagnosis Quiz

Liver Function Diseases

• Scenario: 56-year-old male with fatigue, jaundice, dark urine, and abdominal discomfort. History of heavy alcohol use (20 years). Examination revealed scleral icterus and palpable hepatomegaly. Elevated ALT (alanine aminotransferase), AST (aspartate aminotransferase) and alkaline phosphatase levels

• Likely Diagnosis: Alcoholic liver disease, particularly alcoholic hepatitis or cirrhosis

• Further Tests: Liver function tests (LFTs), complete blood count (CBC), coagulation profile, serum albumin, imaging studies (ultrasound), and liver biopsy (if indicated).

Kidney Function Diseases

• Patient: 45-year-old woman with persistent headaches, shortness of breath, and swelling in legs and ankles. History of obesity and type 2 diabetes. Examination revealed hypertension (160/95 mmHg) and bilateral pedal edema

• Laboratory Results: High serum creatinine (2.1 mg/dL), high blood urea nitrogen (BUN) (35 mg/dL), low estimated glomerular filtration rate (eGFR) (40 mL/min), proteinuria (3+), hematuria (2+)

• Likely Diagnosis: Chronic kidney disease (CKD) due to diabetic nephropathy.

Blood/Heart Diseases

• Patient: 60-year-old male with fatigue, palpitations, easy bruising, weight loss, and night sweats. History of coronary artery disease and myocardial infarction (5 years prior).

• Laboratory Results: Low hemoglobin (9.0 g/dL), low hematocrit (27%), low serum iron (30 µg/dL), low ferritin (10 ng/mL), high total iron-binding capacity (TIBC) (450 µg/dL), microcytic, hypochromic red blood cells on peripheral blood smear

• Likely Diagnosis: Iron deficiency anemia, possibly worsened by chronic disease.

Diabetes Mellitus

• Patient: 48-year-old woman with excessive thirst, frequent urination, unexplained weight loss over a month, and fatigue. History of obesity and hypertension. Family history of diabetes

• Laboratory Results: High fasting plasma glucose (180 mg/dL), high hemoglobin A1c (9.2%), normal serum creatinine (0.9 mg/dL), glycosuria (positive)

• Likely Diagnosis: Type 2 Diabetes Mellitus

Acidosis Disease (Case 1)

• Patient: 34-year-old man with confusion, lethargy, rapid breathing, nausea, vomiting, and abdominal pain. History of Type 1 Diabetes Mellitus. Respiratory rate: 28 breaths per minute

• Laboratory Results: Low pH (7.27), low bicarbonate (HCO3-) (15 mEq/L), low PaCO2 (30 mmHg), elevated anion gap (16 mEq/L)

• Likely Diagnosis: Diabetic ketoacidosis (DKA)

Acidosis Disease (Case 2)

• Patient: 56-year-old man with weakness, confusion, and shortness of breath. History of chronic obstructive pulmonary disease (COPD) and smoking. Respiratory rate: 32 breaths per minute, BP 110/70 mmHg

• Laboratory Results: Low pH (7.29), high PaCO2 (65 mmHg), low PaO2 (50 mmHg), normal bicarbonate (HCO3-) (24 mEq/L)

• Likely Diagnosis: Acute respiratory acidosis due to COPD exacerbation

Electrolyte Imbalance Disease

• Patient: 42-year-old woman with muscle weakness, fatigue, abdominal cramping, increased thirst, and frequent urination (polyuria). History of hypertension.

• Laboratory Results: Low serum sodium (130 mEq/L), low serum potassium (3.0 mEq/L), and other abnormal electrolyte levels (serum chloride and bicarbonate)

• Likely Diagnosis: Hyponatremia and hypokalemia, possibly resulting from diuretic use or other causes of potassium loss

Alkalosis Disease (Case Study)

• Patient: 60-year-old man with dizziness, palpitations, tingling sensations in fingers, and hyperventilation. History of COPD

• Laboratory Results: High pH (7.48), low PaCO2 (32 mmHg), normal bicarbonate (HCO3-) (24 mEq/L)

• Likely Diagnosis: Respiratory alkalosis due to hyperventilation, possibly related to anxiety.

Lipid Diseases

• Patient: 52-year-old male with no significant medical problems. Reports a sedentary lifestyle and a diet high in saturated fats. Family history of cardiovascular disease.

• Laboratory Results: High total cholesterol (250 mg/dL), high LDL cholesterol (160 mg/dL), low HDL cholesterol (35 mg/dL), and slightly high triglycerides (180 mg/dL)

• Likely Diagnosis: Hyperlipidemia (specifically elevated total cholesterol, LDL cholesterol, and slightly elevated triglycerides), possibly contributing as a risk factor for cardiovascular disease.

Test your knowledge on liver disease diagnosis and associated laboratory assessments. This quiz covers important symptoms, diagnostic tests, and factors contributing to liver issues, particularly in patients with a history of alcohol use. Delve into the nuances of chronic liver disease and its implications.