High School

A 55-year-old woman is brought in by her daughter, who claims that her mother has lost 4 pounds over the last month, has a poor appetite, and complains of nausea. She has vomited twice over the past week. History is significant for alcoholism for the past 15 years and hypertension and diabetes for the past 5 years, for which she takes no treatment. She has been drinking 2 pints of beer almost every day for the past 20 years and greater quantities on weekends.

Vitals:
- BP: 140/100 mm Hg
- HR: 102/min
- RR: 20/min
- Temp: 99.8 degrees F

Physical exam reveals hepatomegaly. A liver biopsy reveals ballooning degeneration, spotty necrosis, and polymorphonuclear infiltration.

What is the most likely diagnosis?

1. Alcoholic fatty liver
2. Alcoholic hepatitis
3. Alcoholic cirrhosis
4. Alcoholic siderosis
5. Hepatocellular carcinoma

Answer :

Final answer:

The most likely diagnosis is alcoholic hepatitis.

Explanation:

The most likely diagnosis for the patient's symptoms and medical history is alcoholic hepatitis.

Alcoholic hepatitis is inflammation of the liver caused by excessive alcohol consumption over a long period of time. The patient's history of alcoholism, along with the physical exam findings of hepatomegaly and liver biopsy results of ballooning degeneration, spotty necrosis, and polymorphonuclear infiltration support this diagnosis.

Treatment for alcoholic hepatitis includes stopping alcohol consumption, supportive care, and addressing any complications or underlying conditions.

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