7. A patient with a provisional diagnosis of depression was sent to the laborato

Question

7. A patient with a provisional diagnosis of depression was sent to the laboratory for a routine workup. The complete blood cell count was unremarkable except for an elevated erythrocyte mean cell volume. Results of the urinalysis were unremarkable. The serum chemistry testing revealed slightly increased aspartate aminotransferase (AST), total bilirubin, and high-density lipoproteins (HDL). All other chemistry results, including glucose, urea, creatinine, cholesterol, pH, bicarbonate/carbon dioxide (pCO2), alanine aminotransferase (ALT), sodium, and potassium, were within the reference intervals. The physician suspects ethanol abuse; however, the patient denies an alcohol use. Subsequent testing revealed a serum y- glutamyltransferase (GGT) three times the upper limit of the reference interval. No ethanol was detected in serum, and screening tests for infectious forms of hepatitis were negative a. Are these results consistent with a patient who is consuming hazardous quantities of ethanol? Which data support your conclusion? b. What additional testing would you recommend to rule ethanol abuse in or out?

Explanation / Answer

Answer:

1. Are these results consistent with a patient who is consuming hazardous quantities of ethanol?

Yes, there is a positive correlation between levels of Gamma-Glutamyltransferase (GGT) in serum of severe alcohol abuse people. Therefore, the results are consistent with a patient who is consuming hazardous quantities of ethanol because subsequent testing revealed a serum GGT three times the upper limit of normal with no need of ethanol presence in serum. It can be concluded that "elevated aspartate aminotransferase, total bilirubin, and high-density lipoprotein levels" in the above patient so that it is alcoholic fatty liver disease related to both severe intake of alcohol & eating disorders

2: Other tests required to examine the serum or urine analysis of "acetaldehyde" adduct levels that potentially represent markers of alcohol abuse

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