#june2020mccqe1
A 27-year-old African American man visits his primary care physician because of recent onset of “yellowness in the white of his eyes.” His recent history is significant for a “chest cold” for which he is taking trimethoprim-sulfamethoxazole; he is also taking fluoxetine for depression. On examination, the sclera are icteric and the mucosa beneath the tongue appears yellow. No hepatosplenomegaly is present. Laboratory studies are as follows:
Hemoglobin 11.1 g/dL
Hematocrit 34%
Total bilirubin 6.2 mg/dL
Conjugated (direct) bilirubin 0.8 mg/dL
Alkaline phosphatase 77
AST (SGOT) 24
ALT (SGPT) 22
Which of the following is the most likely explanation for this patient’s jaundice?
(A) Acute infectious hepatitis
(B) Cholestatic liver disease
(C) Drug reaction from fluoxetine
(D) Drug reaction from trimethoprim-sulfamethoxazole
A 27-year-old African American man visits his primary care physician because of recent onset of “yellowness in the white of his eyes.” His recent history is significant for a “chest cold” for which he is taking trimethoprim-sulfamethoxazole; he is also taking fluoxetine for depression. On examination, the sclera are icteric and the mucosa beneath the tongue appears yellow. No hepatosplenomegaly is present. Laboratory studies are as follows:
Hemoglobin 11.1 g/dL
Hematocrit 34%
Total bilirubin 6.2 mg/dL
Conjugated (direct) bilirubin 0.8 mg/dL
Alkaline phosphatase 77
AST (SGOT) 24
ALT (SGPT) 22
Which of the following is the most likely explanation for this patient’s jaundice?
(A) Acute infectious hepatitis
(B) Cholestatic liver disease
(C) Drug reaction from fluoxetine
(D) Drug reaction from trimethoprim-sulfamethoxazole
Last edited by a moderator: