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Day Rule in Rule Out

The patient presented with a history of abdominal pain, weight loss, fever, and anorexia. On examination, the patient appeared pale and icteric, with lymphadenopathy and an enlarged, distended liver. Laboratory tests showed anemia and elevated liver enzymes. Given the patient's risk factors including a family history of tuberculosis and previous sexual contact, hepatic tuberculosis was considered to explain the abdominal symptoms and abnormal liver function tests.

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Pernel Jose Alam Micubo
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49 views5 pages

Day Rule in Rule Out

The patient presented with a history of abdominal pain, weight loss, fever, and anorexia. On examination, the patient appeared pale and icteric, with lymphadenopathy and an enlarged, distended liver. Laboratory tests showed anemia and elevated liver enzymes. Given the patient's risk factors including a family history of tuberculosis and previous sexual contact, hepatic tuberculosis was considered to explain the abdominal symptoms and abnormal liver function tests.

Uploaded by

Pernel Jose Alam Micubo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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HIV-associated Hepatic TB

DAY RULE IN RULE OUT


Hx CC: Abdominal Pain

(Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798224/#!po=14.7059)

Bloatedness, weight loss, Fever, Anorexia, Cough

Persistence of abdominal pain


Worsening of anorexia
Generalized weakness
FH: father died of TB, caregiver of father, niece have TB
PSH: allegedly has had prev. sexual contact with girlfriend
PE
1 Pale with icteric sclera
(source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798224/#!po=14.7059)

Multiple cervical lymphadenopathies

(source: Harrison’s19th ed)


Cachexia and prominent temporal wasting

Abdomen: globular, distended with palpable liver edge

(source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425874/)

LABS:
Decreased RBC,Hgb, Hct; Increased neutrophils, RDW; Increased AST, ALP
(source: harrison’s 19th)
2 Multiple vascular rashes in extremities with clear discharge when ruptured
3 HRZE 3 tabs OD and Vit. B, FeSo4, MV

(source: https://academic.oup.com/cid/article/50/10/1377/376993)

LABS:
Decreased RBC,Hgb, Hct; Increased neutrophils, RDW; Increased AST, ALP
(source: harrison’s 19th)
4
5 LABS:
Decreased RBC,Hgb, Hct; Increased neutrophils, RDW

(source: harrison’s 19th)

Grade II bipedal edema


Decrease albumin

(source: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2222-2)
6 LABS:
Decreased RBC,Hgb, Hct; Increased neutrophils, RDW
(source: harrison’s 19th)
7

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