Cholestasis is the most likely diagnosis

The pattern is hepatocellular injury, not cholestatic. ALT is extremely high (8,300 IU/L) with only modest alkaline phosphatase and bilirubin rises, which points to acute severe hepatocellular necrosis. Do you remember in which setting this is classically seen? 

Please go back and re-consider.

Alters ammonia metabolism by colonic bacteria

Map: Andrew Hall (1102)
Node: 20966
Score:

reset

OpenLabyrinth
OpenLabyrinth is an open source educational pathway system

Review your pathway

  • Ramipril
  • Oral prednisolone (glucocorticoid)
  • Nebulized ipratropium (SAMA, anticholinergic)
  • Metolazone
  • Ask the patient to walk or change position (risk of falling).
  • Inhalational fluticasone (glucocorticoid)
  • Intravenous resluzimab (IL-5 antibody)
  • State that assessment cannot continue without a clear image
  • Bisoprolol
  • Ask the patient to take a clear photo of the wound (10–15 cm distance, adequate lighting) and upload it to the app
  • The patient presentation is not due to paracetamol overdose
  • Cholestasis is the most likely diagnosis

Reminder

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FINISH

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