He admits to a history of moderate-to-high alcohol intake


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He returns to your clinic for follow-up blood work, and four values catch your attention:

AST 430 U/L

ALT 535 U/L

Bilirubin 41 mg/dl

BG 60 mg/dl

He admits to a history of moderate-to-high alcohol intake (>12 drinks/week for >10 years). He is slightly febrile (99.7°F) and has abdominal tenderness. He also admits to taking several, different over-the-counter pain relievers of different brands daily and continuously to combat the pain in his knee, in addition to his prescription(s) in Part One. You decide to run a toxicology lab, and it reveals a blood acetaminophen concentration of 58 µg/mL.

  • What is the diagnosis at this point in his case? Please explain the mechanism for how this occurs/occurred, and the antidote's mechanism of action.
  • What is the subsequent management and treatment for this individual related to the diagnosis in Part One.

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Science: He admits to a history of moderate-to-high alcohol intake
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