A 50 year old lady presented with history of pain upper abdomen, nausea, and decreased appetite for 5 days. She had undergone cholecystectomy 2 years back. Her bilirubin was 10 mg/d1, SGPT 900 1U/L SGOT 700 IU/L and serum alkaline phosphatase was 280 IU/L. What is the most likely diagnosis ?
Answer is C (Acute viral Hepatitis) Prodromal symptoms of nausea and anorexia, presence of pain in upper abdomen together with characteristic laboratory features (elevated bilirubin, elevated SCOT and SGPT>500 with SGPT > SGOT, and elevated alkaline phosphates to < 3 times normal) suggest the diagnosis of viral hepatitis. Diagnosis of Acute viral Hepatitis Prodromal Symptoms Anorexia, Nausea, Vomiting Fatigue, malaise, ahralgic, tuvalgia, Fever Clinical Jaundice and associated Signs Clinical Jaundice (Also dark urine, clay coloured stool) Tender Hepatomegaly (Right upper abdomen pain/discomfo) Characteristic Laboratory Parameters Bilirubin AST/ALT Alkaline Phosphate Albumin + Prothrombin time Elevated Elevated Normal to < 3 times normal Usually normal (Both fractions may be Elevated usually >500 IU/L (N=30 to 120 1U/L) elevated) ALT>AST (N=3 to 13 KAU) Note: ALT is synonymous with SGPIQ AST is synonymous with SGOT2
Acute pancreatitis
Acute cholangitis
Acute viral hepatitis
Posterior penetration of peptic ulcer