Question

55 year old man presents with fatigue for past month. PMI for hepatomegaly due to fatty liver. He drinks 4 shots a day for several years but does not smoke. H has pallor of skin and mucus membranes. Labs - anemic, nml WBC, MCV increased, nml platelets, high blood close.

- megaloblastic anemia d/t folate deficiency.

- heavy alcohol use, pancytopenia, significant macrocytoszs
-limited body stores (nutrition poor diet linked with alc abuse = folate def in 5-10wks)

Answer 1

A 55-year-old man's symptoms and lab tests indicate chronic liver failure possibly due to excessive alcohol use, leading to a fatty liver, fatigue, pallor, and megaloblastic anemia from folate deficiency.

Step-by-step explanation:

The condition described in the question is related to a man suffering from multiple health issues indicative of chronic liver failure, possibly due to excessive alcohol intake which has led to a fatty liver. His symptoms include fatigue, pallor of skin and mucus membranes, and anemia with increased mean corpuscular volume (MCV), pointing towards megaloblastic anemia due to folate deficiency. This deficiency can be exacerbated by alcohol consumption, as a poor diet and optimal nutrient absorption are affected, leading to depleted body stores of folate.

Fatty liver is commonly associated with abnormal lipid storage in the liver and can lead to disruptions in liver function, which might result in complications such as jaundice. While managing this patient, addressing the underlying cause, such as reducing alcohol intake, and improving nutrition, particularly replenishing folate, is crucial.