2013 sg4 student

Small Group 4 December 2, 2013 2pm Case 1: A 37 year old man presents to the emergency room complaining of fevers, generalized aches, anorexia, and fatigue, followed by nausea, vomiting and jaundice for the past week. He returned to Miami two days ago after spending the past week at a business convention in New Orleans. He admits to frequent alcohol and occasional acetaminophen use. He is divorced and sexually active. His mother and sister have symptomatic gallstone disease. Physical examination is significant for conjunctival icterus, tender hepatomegaly, and a palpable spleen tip. He is able to perform a number connection test in 25 seconds (normal). Lab Data: WBC (NL 4-10) 14,880 cells/mm 3 with 59% neutrophils Hb (NL 12.5-15.5) 15 mg/dL Platelet Count (NL 140- 450) 160,000 cells/mm 3 ALT (NL 5-40) 75 IU/mL AST (NL 5-40) 190 IU/mL Alkaline Phosphatase (NL 38-126) 160 IU/L Total Bilirubin (NL 0.2- 1.2) 8 mg/dl Direct Bilirubin (NL <0.3) 7 mg/dl Albumin (NL 3.5-4.8) 3.2 gm/dl Total Protein (NL 6.3-8.2) 7.0 gm/dl Prothrombin Time (NL 12- 14) 16 seconds Hep B surface antigen (sAg) Negative Hep A IgG Negative Hep C Ab Negative

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Case 1

Small Group 4December 2, 20132pm

Case 1: A 37 year old man presents to the emergency room complaining of fevers, generalized aches, anorexia, and fatigue, followed by nausea, vomiting and jaundice for the past week. He returned to Miami two days ago after spending the past week at a business convention in New Orleans. He admits to frequent alcohol and occasional acetaminophen use. He is divorced and sexually active. His mother and sister have symptomatic gallstone disease.

Physical examination is significant for conjunctival icterus, tender hepatomegaly, and a palpable spleen tip. He is able to perform a number connection test in 25 seconds (normal).

Lab Data:WBC (NL 4-10)14,880 cells/mm3 with 59% neutrophils

Hb (NL 12.5-15.5)15 mg/dL

Platelet Count (NL 140-450)160,000 cells/mm3

ALT (NL 5-40)75 IU/mL

AST (NL 5-40)190 IU/mL

Alkaline Phosphatase (NL 38-126)160 IU/L

Total Bilirubin (NL 0.2-1.2)8 mg/dl

Direct Bilirubin (NL

Student Handbook 2013

Vonthunen 2013 student

SG4-15 Preventing Falls Scaffolding Operation

· • SPAM 150C 65-66 SPCJ 4D34 — N/ o SPTU 240 R3 SPTU 48 R2 ... SPAM 150C ( automatic doubling function) SG4/1 2 SG4/1 1 60ms 1.25x SG4/1=1 SGF/I SPCJ 4D34