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Which laboratory blood test results indicates that cirrhosis of the liver has no

ID: 3482977 • Letter: W

Question

Which laboratory blood test results indicates that cirrhosis of the liver has not developed in this patient as a result of cystic fibrosis? List the clinical evidence and provide a brief explanation for each test. (15pts)

Patient Case Table 15.2 Laboratory Blood Test Results

  Na

137 meq/L  

  MCHC

29 g/dL  

  AST

16 IU/L  

  K

3.8 meq/L  

  Plt

187,000/mm3  

  ALT

20 IU/L  

  Cl

102 meq/L  

  WBC

18,900/mm3  

  T Bilirubin

1.0 mg/dL  

  HCO3

24 meq/L  

  • PMNs

74%  

  T Protein

7.3 g/dL  

  BUN

19 mg/dL  

  • Bands

6%  

  Alb

3.8 g/dL  

  Cr

0.7 mg/dL  

  • Lymphs

17%  

  Vitamin A

40 mg/dL  

  Glu, fasting

109 mg/dL  

  • Monos

3%  

  Vitamin D, 25OH

43 ng/mL  

  Hb

11.8 g/dL  

  Ca

8.3 mg/dL  

  Vitamin E

0.2 mg/dL  

  Hct

35.1%  

  PO4

2.9 mg/dL  

  PT

11.4 sec  

  MCV

77 fL  

  Mg

2.1 mg/dL  

  PTT

34.8 sec  

Patient Case Table 15.2 Laboratory Blood Test Results

  Na

137 meq/L  

  MCHC

29 g/dL  

  AST

16 IU/L  

  K

3.8 meq/L  

  Plt

187,000/mm3  

  ALT

20 IU/L  

  Cl

102 meq/L  

  WBC

18,900/mm3  

  T Bilirubin

1.0 mg/dL  

  HCO3

24 meq/L  

  • PMNs

74%  

  T Protein

7.3 g/dL  

  BUN

19 mg/dL  

  • Bands

6%  

  Alb

3.8 g/dL  

  Cr

0.7 mg/dL  

  • Lymphs

17%  

  Vitamin A

40 mg/dL  

  Glu, fasting

109 mg/dL  

  • Monos

3%  

  Vitamin D, 25OH

43 ng/mL  

  Hb

11.8 g/dL  

  Ca

8.3 mg/dL  

  Vitamin E

0.2 mg/dL  

  Hct

35.1%  

  PO4

2.9 mg/dL  

  PT

11.4 sec  

  MCV

77 fL  

  Mg

2.1 mg/dL  

  PTT

34.8 sec  

Explanation / Answer

Cystic fibrosis is diagnosed by genetic test (finding the CFTR gene) and sweat test.

Sweat test: measures amount of salt chemicals (sodium and chloride ) in sweat.

Normal: less than 40 mmol /L

Abnormal: 60 mmol /L

Here,

AST ( Aspartate transaminase) and ALT (Alanine transaminase) is under normal range indicating that liver is normal.

AST: 10 - 40 IU/L

ALT: 7 - 56 IU/L

Thus, cirrhosis of liver has not developed in this patient due to cystic fibrosis.

Also,

Albumin is in normal range (3.5 - 5.0 grams/ dL)

Bilirubin is in normal range (0.1 - 1.2 mg/ dL )

Na+ is in normal range (135 - 145 mEq/L). Hyponatremia occurs in case of dehydration , heart ,kidney and liver problems, intake of diuretics, drinking too much water. In this case sodium levels are also normal.

Chloride level: 96 - 106 mEq/L. Thus, it is also normal in the above case.

Normal platelets: 150000 to 450000 per cubic mm of blood

WBC count : 4300- 10800 cells per cubic mm of blood

This is more in the person, indicating there is some infection in the body.

PMN - 40 to 80%

Lymphocytes -20 to 40 % ( slight less in the case)

Monocyte - 4 to 8%

Bands - 0 to 5% ( slight more )

Thus, laboratory tests are interpreted.

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