A married 30-year-old woman with no past medical history presents to the emergency department with complaints of dull aching pain in the right upper quadrant of her abdomen and her lumbar region. The discomfort was initially associated with low-grade fevers that were relieved by over-the-counter antipyretics. Recently, the fevers have only temporarily been relieved with antipyretics.
These symptoms are associated with nausea, vomiting, decreased appetite, yellowish discoloration of the sclera (shown), and a 10-kg weight loss. The patient denies any history of change in bowel habits, melena, clay-colored stools, hematemesis, or other symptoms.
Her medical history includes cholecystitis during pregnancy, which
was managed with antibiotics. She subsequently had a caesarean section
and cholecystectomy. She is a nonsmoker and doesn't consume alcohol. She
denies any illicit drug use or any recent travel history and is a
resident of Pakistan. On examination, she is a young, anxious-appearing
woman, with a regular heart rate of 100 beats per minute, blood pressure
of 110/70 mm Hg, respiratory rate of 24 breaths per minute, and a
temperature of 102oF. She is jaundiced. Abdominal examination
reveals right upper quadrant tenderness on deep palpation with tender
hepatomegaly. She has diminished breath sounds and dullness on
auscultating the right lower lung. The rest of her physical examination
is unremarkable.
The patient's laboratory results are shown. Which tests are abnormal?
There is a right-sided pleural effusion with blunting of the costophrenic angle (circled).
The pleural effusion is aspirated and sent to the laboratory for analysis. Pleural effusions may be either transudative or exudative. Light's criteria are used to differentiate between transudative and exudative processes.
There are multiple hypodense lesions (circles) within the right lobe of the liver that likely correlate with the abnormality seen on ultrasound.
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The patient's laboratory results are shown. Which tests are abnormal?
There is a right-sided pleural effusion with blunting of the costophrenic angle (circled).
The pleural effusion is aspirated and sent to the laboratory for analysis. Pleural effusions may be either transudative or exudative. Light's criteria are used to differentiate between transudative and exudative processes.
There are multiple hypodense lesions (circles) within the right lobe of the liver that likely correlate with the abnormality seen on ultrasound.
WHAT IS YOUR DIAGNOSIS ?
Send it to facebook or asdatguy@gmail.com
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