Case 3 – Use for questions 50-59 TJ is a 51-year-old male (1…
Case 3 – Use for questions 50-59 TJ is a 51-year-old male (100 kg, BMI 35) with a history of end stage liver disease and cirrhosis with ascites due to primary biliary cirrhosis. He has been non-compliant with his home medications. He presented to the emergency department at the hospital in Backwoods, WI with respiratory distress and a GI bleed. He states he doesn’t drink or use tobacco products. Due to impending respiratory failure, he was intubated using RSI at the referring hospital, started on a midazolam infusion, flown to your hospital, and directly admitted to the ICU. In your ICU, his vitals were: HR 115 bpm, BP 87/50, RR 22 bpm; his labs were: PaO2=96 on 100% FiO2, Hct=16 (normal range 34-46%), Hgb=5.2 (normal range 11.6-15.6), SCr=5.6 (baseline 1.2), AST=245 (normal range 0-40), ALT=356 (normal range 13-59), TBili=17.3 (normal range 0-1.4), INR=1.6 (normal range 0.9-1.2). AST, ALT, and TBili are consistent with PCP visit 3 months ago.