1. The following laboratory test results were obtained in a patient with severe jaundice, right upper quadrant abdominal pain, fever, and chills. Serum alkaline phosphatase Four times normal Serum cholesterol Increased AST (SGOT) Normal or slightly increased 5’-Nucleotidase Increased Total serum bilirubin 25 mg/dL Conjugated bilirubin 19 mg/dL Prothrombin time Prolonged but improves with a vitamin K injection What is the most likely cause of jaundice in the patient? Rationalize your answers.
Electron Transport Chain
The electron transport chain, also known as the electron transport system, is a group of proteins that transfer electrons through a membrane within mitochondria to create a gradient of protons that drives adenosine triphosphate (ATP)synthesis. The cell uses ATP as an energy source for metabolic processes and cellular functions. ETC involves series of reactions that convert redox energy from NADH (nicotinamide adenine dinucleotide (NAD) + hydrogen (H)) and FADH2(flavin adenine dinucleotide (FAD)) oxidation into proton-motive force(PMF), which is then used to synthesize ATP through conformational changes in the ATP synthase complex, a process known as oxidative phosphorylation.
Metabolism
Picture a campfire. It keeps the body warm on a cold night and provides light. To ensure that the fire keeps burning, fuel needs to be added(pieces of wood in this case). When a small piece is added, the fire burns bright for a bit and then dies down unless more wood is added. But, if too many pieces are placed at a time, the fire escalates and burns for a longer time, without actually burning away all the pieces that have been added. Many of them, especially the larger chunks or damp pieces, remain unburnt.
Cellular Respiration
Cellular respiration is the cellular process involved in the generation of adenosine triphosphate (ATP) molecules from the organic nutritional source obtained from the diet. It is a universal process observed in all types of life forms. The glucose (chemical formula C6H12O6) molecules are the preferred raw material for cell respiration as it possesses a simple structure and is highly efficient in nature.
1. The following laboratory test results were obtained in a patient with severe jaundice, right upper quadrant abdominal pain, fever, and chills.
Serum alkaline phosphatase Four times normal
Serum cholesterol Increased
AST (SGOT) Normal or slightly increased
5’-Nucleotidase Increased
Total serum bilirubin 25 mg/dL
Conjugated bilirubin 19 mg/dL
Prothrombin time Prolonged but improves with a vitamin K injection
What is the most likely cause of jaundice in the patient? Rationalize your answers.
2. The laboratory technologist noticed as he was placing the serum sample cup into the automated chemistry instrument that the serum appeared to have When the results of the chemistry test for this patient appeared on the screen, the technologist saw that the total bilirubin for this patient was increased and that other liver function tests were also abnormal. The technologist reviewed the laboratory results on this patient from the past several days. Among the following choices, what is the most probable diagnosis? Refer to the laboratory results and rationalize your answer.
a. Gilbert’s syndrome
b. Gallstones
c. Dublin–Johnson syndrome
d. Non-alcoholic fatty liver disease
e. Obstructive Jaundice
*cite references
![Test Results of the Patient With the Icteric Specimen
Test
Reference Range
Results
Day 1
Day 2
Total protein (g/dL)
Albumin (g/dL)
Total bilirubin (mg/dL)
Direct bilirubin (mg/dL)
ALT (U/L)
Alkaline phosphatase (U/L)
GGT (U/L)
AST (U/L)
Amylase (U/L)
6.4-8.3
7.4
7.2
3.5-5.2
4.4
4.1
0.0-2.0
3.5
3.6
0.0-0.2
2.3
2.1
<45
220
208
53-128
374
380
<55
178
170
<38
190
176
28-100
94](/v2/_next/image?url=https%3A%2F%2Fcontent.bartleby.com%2Fqna-images%2Fquestion%2F5ad58af8-98f9-4d77-9bd5-8b68551ce5eb%2F40aab5a3-1236-4abb-a8b0-e3222a76f783%2Fvbvsw5_processed.png&w=3840&q=75)
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