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3566 Medicine

A 60-year-old female complains of dry mouth and a gritty sensation in her eyes. She states it is sometimes difficult to speak for more than a few minutes. There is no history of diabetes mellitus or neurologic disease. The patient is on no medications. On exam, the buccal mucosa appears dry and the salivary glands are enlarged bilaterally. The next step in evaluation is:

ALip biopsy
BSchirmer test and measurement of autoantibodies
CIgG antibody to mumps virus
DUse of corticosteroids
Medicine
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3570 Medicine

A 45-year-old woman presents to the emergency department with a 1-week history of jaundice, anorexia, and right upper quadrant discomfort. On examination she is icteric, with a tender right upper quadrant and liver span of 14 cm. There is no shifting dullness or pedal edema and the heart and lungs are normal. On further inquiry, she reports consuming 1 bottle of wine a day for the past 6 months. Which of the following laboratory tests is most characteristic of a patient with jaundice secondary to alcoholic hepatitis?

Aratio of AST : ALT is 3 :1 and the AST is 500 U/L
Bratio of AST : ALT is 2 :1 and the AST is 250 U/L
Cratio of AST : ALT is 1 :1 and the AST is 500 U/L
Dratio of AST : ALT is 1 :1 and the AST is 250 U/L
Medicine
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