A patient has been prescribed antacids and an antibiotic to eradicate Helicobacter pylori. The diagnosis is most likely

A. Steroid injections will be administered daily: This is incorrect; steroid therapy may exacerbate Cushing's disease. The condition is often due to excessive production of cortisol, not a deficiency.

B. Weight gain and edema are present: Hyperaldosteronism, often associated with Cushing's syndrome, leads to sodium and water retention, resulting in weight gain and edema.

C. Painful leg cramps are common from hyperkalemia: Hyperaldosteronism typically causes hypokalemia, not hyperkalemia, leading to muscle cramps, not leg pain from hyperkalemia.

D. Decreased amount of body hair is frequently seen: Cushing's disease often leads to hirsutism (increased body hair), not a decrease.

26. A patient is admitted to the emergency department (ED) following an overdose of acetaminophen (Tylenol) and is diagnosed with cirrhosis. Which laboratory finding is consistent with the diagnosis?

1. elevated serum protein hyperproteinemia
2. decreased serum liver enzymes (ALT).
3. elevated number of platelets thrombocytosis)
4. decreased level of clotting factors.

Correct answer:

A. Elevated serum protein hyperproteinemia: In cirrhosis, serum protein levels, particularly albumin, are often decreased due to impaired liver synthesis.

B. Decreased serum liver enzymes (ALT): In cirrhosis, liver enzyme levels such as ALT (alanine aminotransferase) are typically elevated due to liver damage and inflammation.

C. Elevated number of platelets (thrombocytosis): Cirrhosis often leads to thrombocytopenia (decreased platelet count) due to splenomegaly and decreased production of thrombopoietin.

D. Decreased level of clotting factors: The liver synthesizes most clotting factors, and in cirrhosis, the production of these factors is impaired, leading to decreased levels and increased bleeding risk.