A 48-Year-Old Woman Comes to the Office After Abnormal Serum

question 264

Multiple Choice

A 48-year-old woman comes to the office after abnormal serum liver chemistry results were found during a life insurance medical evaluation.  She has no chronic medical issues and takes no medications.  The patient says she has felt excessively tired lately, which she attributes to menopause.  She has had no hot flashes, changes in sleep pattern, anorexia, or weight loss.  The patient does not use tobacco, alcohol, or illicit drugs.  She works in an accounting firm.  Her father died at age 62 from an unknown liver disease.  Vital signs are within normal limits.  BMI is 30 kg/m².  She has small bilateral xanthelasmata but no scleral icterus.  The thyroid is not enlarged.  Cardiopulmonary examination is unremarkable.  The abdomen is soft and nontender with no hepatosplenomegaly.  She has no skin rash.  Current laboratory results are as follows: Abdominal ultrasonography reveals a normal-sized liver and no gallstones.  Intrahepatic and common bile ducts are normal.
Which of the following is most likely to help establish the diagnosis in this patient?

• A)Alpha-1 antitrypsin phenotype
• B)Anti-smooth-muscle antibody
• C)Antimitochondrial antibody
• D)Serum ceruloplasmin level
• E)Serum ferritin and transferrin saturation

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Definitions:

Bank Failures

Occurrences where a bank is unable to meet its obligations to its depositors or other creditors because it has become insolvent or too illiquid to meet its liabilities.

Commercial Banks

Financial institutions that offer a wide range of services, including deposits, loans, and other financial products to businesses and individuals.

Incomes

Regular financial earnings obtained from labor services or investment gains.

U.S. Currency

The official monetary system of the United States, consisting of the dollar and its denominations.