問題詳情

四、病例判讀:請依據題目所敘述之病史、臨床症狀及實驗室檢查結果判讀診斷下列病例。(25 分)Dog:Eight-year-old Male Canine Bull Terrier.History:Intermittent vomit, anorexia and jaundice of three weeks’ duration.Physical examination:Scleral membranes are icteric and hepatomegaly is present.Initial assessment : Vomiting and anorexia are nonspecific signs most commonlyassociated with hepatic, pancreatic, renal or intestinal disease. Presence of icterus andhepatomegaly suggests that liver is of particular interest. Hematology and chemistryprofiles are warranted with particular emphasis on aforementioned organ systems.Laboratory data:Hematology:PCV=32%, Hb=11.1g/dL, RBC=4.87×106/μL, Reticulocytes=1.3%,WBC=39,800/μL, Neutrophils(Band)=400/μL, Neutrophils(Segmented)=35,800/μL,Eosinophils=0/μL, Lymphocytes=2,400/μL, Monocytes=1,200/μL.Serum biochemistry:BUN=13.5 mg/dL, Creatinine=0.6 mg/dL, Glucose=85 mg/dL,T. bilirubin=4.6 mg/dL, D. bilirubin=3.9 mg/dL, Total protein=7.0 g/dL, Albumin=2.8 g/dL,ALT = 449 U/L, ALP = 800 U/L, Amylase = 568 U/L, Sodium = 146 mmol/L,Potassium = 4.5 mmol/L, Chloride = 120 mmol/L, Calcium = 10.2 mg/dL,Phosphorus=4.2 mg/dL, Cholesterol=480 mg/dL, Triglyceride=180 mg/dL.Urinalysis : Color : Orange, Turbidity : Clear, Sp.gr = 1.020, pH = 6.5, Protein :Negative, Glucose : Negative, Ketone : Negative, Bilirubin = 4+, Occult blood :Negative, Urine sediment examination:WBC:Negative, RBC:Negative, Epithelialcells:Negative, Bacteria:Negative, Casts:Negative, Crystals:Bilirubin.

參考答案

答案:C
難度:適中0.606061
統計:A(3),B(5),C(20),D(4),E(0)