George Jones is admitted to the hospital with abdominal pain.Upon physical examination, the attending physician notices a yellow ring around George's green eyes.George has a significant swelling in his abdomen, and has been suffering from swollen joints for the last month.The physician runs a battery of labs.The results are below: \(\begin{array}{|l|l|l|}
\hline\text { TEST } & \text { George Jones } & \text { Reference Range } \
\hline \text { PT } & 16.8 \mathrm{sec} & 11-13 \mathrm{sec} \
\hline \text { INR } & 3.85 & \text { NA } \
\hline \text { APTT } & 71 \mathrm{sec} & 23-32 \mathrm{sec} \
\hline \text { BT } & 5 \mathrm{~min} & 2-6 \mathrm{~min} \
\hline \text { Fibrinogen } & 275 \mathrm{mg} / \mathrm{dL} & 200-400 \mathrm{mg} / \mathrm{dL} \
\hline \text { Factor X } & 22 \% & 50 \% \text { activity } \
\hline \text { Factor II } & 21 \% & 50 \% \text { activity } \
\hline \text { Factor VII } & 23 \% & 50 \% \text { activity } \
\hline \text { Factor V } & 28 \% & 50 \% \text { activity } \
\hline \text { Factor XII } & 95 \% & 50 \% \text { activity } \
\hline \text { Factor XI } & 99 \% & 50 \% \text { activity } \
\hline \text { Factor IX } & 30 \% & 50 \% \text { activity } \
\hline \text { RIPA } & 95 \% & 50 \% \text { activity } \
\hline \text { AST } & \text { Elevated } & \text { Normal } \
\hline \text { ALT } & \text { Elevated } & \text { Nomal } \
\hline \text { GGT } & \text { Elevated } & \text { Normal } \
\hline \text { TBL } & \text { Elevated } & \text { Normal } \
\hline \text { DBI } & \text { Elevated } & \text { Nomal } \
\hline
\end{array}\) Based on this information, from what is George most likely suffering?

Question

George Jones is admitted to the hospital with abdominal pain.Upon physical examination, the attending physician notices a yellow ring around George's green eyes.George has a significant swelling in his abdomen, and has been suffering from swollen joints for the last month.The physician runs a battery of labs.The results are below: \(\begin{array}{|l|l|l|}
\hline\text { TEST } & \text { George Jones } & \text { Reference Range } \
\hline \text { PT } & 16.8 \mathrm{sec} & 11-13 \mathrm{sec} \
\hline \text { INR } & 3.85 & \text { NA } \
\hline \text { APTT } & 71 \mathrm{sec} & 23-32 \mathrm{sec} \
\hline \text { BT } & 5 \mathrm{~min} & 2-6 \mathrm{~min} \
\hline \text { Fibrinogen } & 275 \mathrm{mg} / \mathrm{dL} & 200-400 \mathrm{mg} / \mathrm{dL} \
\hline \text { Factor X } & 22 \% & >50 \% \text { activity } \
\hline \text { Factor II } & 21 \% & >50 \% \text { activity } \
\hline \text { Factor VII } & 23 \% & >50 \% \text { activity } \
\hline \text { Factor V } & 28 \% & >50 \% \text { activity } \
\hline \text { Factor XII } & 95 \% & >50 \% \text { activity } \
\hline  \text { Factor XI } & 99 \% & >50 \% \text { activity } \
\hline \text { Factor IX } & 30 \% & >50 \% \text { activity } \
\hline \text { RIPA } & 95 \% & >50 \% \text { activity } \
\hline \text { AST } & \text { Elevated } & \text { Normal } \
\hline \text { ALT } & \text { Elevated } & \text { Nomal } \
\hline \text { GGT } & \text { Elevated } & \text { Normal } \
\hline \text { TBL } & \text { Elevated } & \text { Normal } \
\hline \text { DBI } & \text { Elevated } & \text { Nomal } \
\hline
\end{array}\) Based on this information, from what is George most likely suffering?

Quizplus · Accepted Answer

George's symptoms and lab results, including prolonged PT, APTT, elevated liver enzymes, and low activity of multiple clotting factors, suggest liver disease, which can cause impaired synthesis of clotting factors. The yellow ring around his eyes (Kayser-Fleischer rings) may indicate Wilson's disease, a type of liver disorder.

George Jones Is Admitted to the Hospital with Abdominal Pain