Ella is an attorney who has worked in private practice for 25 years. She estimates she works 70 hours/week between the office and the courtroom. She has attributed her persistent fatigue to her schedule, poor diet (“I usually eat on the run, whatever is available”) and alcohol consumption (“I drink a bottle of wine a couple nights a week, and maybe more at the weekend especially if there are lots of dinners with clients”). Her fatigue has recently worsened and she has been feeling nauseous and light-headed consistently over the last several days. How do you interpret the increases in ALT, AST and LDH and what is the most likely cause of this? Lactate dehydrogenase (LDH) 190 99-191 IU/L Aspartate amino-transferase (AST) 260 12-45 IU/L Alanine aminotransferase (ALT) 76 <34 IU/L

Ella is an attorney who has worked in private practice for 25 years. She estimates she works 70 hours/week between the office and the courtroom. She has attributed her persistent fatigue to her schedule, poor diet (“I usually eat on the run, whatever is available”) and alcohol consumption (“I drink a bottle of wine a couple nights a week, and maybe more at the weekend especially if there are lots of dinners with clients”). Her fatigue has recently worsened and she has been feeling nauseous and light-headed consistently over the last several days. How do you interpret the increases in ALT, AST and LDH and what is the most likely cause of this? Lactate dehydrogenase (LDH) 190 99-191 IU/L Aspartate amino-transferase (AST) 260 12-45 IU/L Alanine aminotransferase (ALT) 76 <34 IU/L

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