A 42-Year-Old Woman Comes to the Office for Follow-Up Due

question 39

Multiple Choice

A 42-year-old woman comes to the office for follow-up due to abnormal liver function studies.  The patient reports no symptoms.  Medical history is significant for primary hypertension, and she has been taking amlodipine for >5 years.  Family history is negative for liver disease.  The patient drinks a glass of wine 3 or 4 times a week but denies smoking or illicit drug use.  Temperature is 37.5 C (99.5 F) , blood pressure is 146/80 mm Hg, and heart rate is 80/min.  BMI is 28 kg/m².  Scleral icterus and palmar erythema are absent.  Cardiopulmonary and abdominal examinations are both unremarkable.  Laboratory studies are as follows: Initial testing 3 months ago showed similar results.  Which of the following most likely explains this patient's persistent laboratory abnormalities?

• A)Alcoholic hepatitis
• B)Alpha-1-antitrypsin deficiency
• C)Autoimmune hepatitis
• D)Drug-induced liver injury
• E)Hepatitis A
• F)Primary biliary cholangitis

---

Definitions:

Perfection Standard

Ideal or benchmark performance criteria in manufacturing or service delivery that represents the highest possible level of quality or efficiency.

Labour On-costs

Additional costs associated with employing staff, beyond their wages or salaries, including payroll taxes, superannuation, and workers' compensation insurance.

Occasional Inefficiencies

Sporadic or irregular instances where processes or systems do not operate at maximum productivity, leading to potential waste or excess costs.

Statistical Control Chart

A tool used in manufacturing and business processes to plot data points over time and identify variances from the norm to detect and control predictable behaviors within a process.