DECISION POINT: Diagnosis & Initial Management

DECISION POINT: Diagnosis & Initial Management

Nurse Rina asks, "Doc, the results are extremely high. What should I do? Is this just viral hepatitis? Do I continue the TB drugs?"

"Reduce the anti tuberculosis drug 4-FDC dose to half. Let's monitor for 3 more days. Maybe his liver is just need some adjusting dose.
"Such high AST/ALT must be a severe infection, possibly cholangitis. Stop the anti tuberculosis drug and start broad-spectrum antibiotics immediately."
"This is a severe Drug-Induced Liver Injury (DILI) from the anti tuberculosis drug.
"This is likely a coincidental acute viral hepatitis. Continue the anti tuberculosis drug to prevent resistance. Give a liver supplement and refer for hepatitis serology.

Map: Tuberculosis Case _1 (1129)
Node: 21488
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"Check Ureum and Creatinine first. His advanced age and vomiting put him at risk for acute kidney injury."
"Prioritize the liver function tests (AST/ALT). The clinical symptoms are strongly suggestive of a hepatobiliary issue."
"Check a Complete Blood Count and CRP. We need to see if there's a secondary infection or anemia."
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Observation under the microscope (plant cell)
DECISION POINT: Diagnosis & Initial Management

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