Thyroid Adrenal and Liverrelated Fatigue Homework Directions

Thyroid, Adrenal and Liver-related Fatigue Homework Directions:

Provide your answers to each question below. All answers must be coherent and in your own words. Make sure to appropriately cite all references in APA style. This entire document must be submitted to your instructor upon completion.

Carolyn, a 58-year-old female, came into your clinic with a chief complaint of acute abdominal pain in the upper right quadrant. Murphy’s sign was positive, marked jaundice was observed, and history revealed recent weight loss, fatigue, and increased alcohol consumption due to a recent divorce. Carolyn denies IV drug use.

Lab results show

increased bilirubin, AST, ALT, and decreased serum albumin. A rapid HIV test was negative.

1. List 3 differential diagnoses and include your reasoning behind each

2. What is the best diagnosis? Explain how you came to this conclusion

3. Explain the pathophysiology of the following symptoms

Increased bilirubin:

Fatigue:

Weight loss:

Solution

1). The three possible differential diagnosis are,

(i). Jaundice

(ii). Liver cirrhosis

(iii). Alcoholism

Jaundice is the medical term for yellow discoloration of the sclera and mucous membranes. Heme moiety of hemoglobin is breakdown into iron and biliverdin in the body. During jaundice, excess breakdown of hemoglobin results in the accumulation of bilirubin (made from biliverdin), which gives yellow coloration to the mucous membranes. The AST, ALT levels, decreased serum albumin levels are indicative of jaundice, alcoholism and liver cirrhosis.

Reference: http://www.medscape.com/viewarticle/710045_3