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ABD US, Labs and Lots of ?'s
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ABD US, Labs and Lots of ?'s

64 yr F R/A('83) SS, rayn'ds,divert Hubby died AML ('09).
ABD US 9-2012:Liver norm size,mild heterogen echogencity,non spec may rep. heptocellular dis. Cyst infer R lobe liver w/couple sm areas internal septa.No solid mass/ductal dilation.Gallbladder w/o stones wall thickening/paracholecystic edema.Common duct norm caliber 5.8. Portions pancreas, which can b visualized, norm size echogencity w/o focal mass/ductal dilation.R kidney norm size echogencity w/o focal mass/hydronephrosis.No mass/calculus.Visualized portions L kidney unremarkable no mass/calculus/hydronephrosis.Spleen norm-portions abdominal aorta/inferior vena cava unremarkable No ascites.
IMPRESSION: Cyst R lobe liver.
Mildy hetergeneous appearance liver, nonspec may represent heptocellular disease. No focal hepatic mass.
EGD 2 weeks B4- gr 2 nonbleeding varices. US, Esoph varices/cirrhosis?.wont do anything unless they look like a bleed BP runs low 100-120. NEW gastro this mo!
ABNORMALS - 1/22/2013
WBC 4.1 L
Plts 102 L biologics, rheumy told me why my plats run 100-115 for yrs..
Bun/Creat 14 L
BUN NORM at 11
BILI 1.1 H
AST 39 H
ALT 43
INR 1.0
PT 10.7
Albumin 4.1
Glob 3.7
A/G ratio 1.1
Alk phos norm at 99, once went 164

1) Explain US/labs? cirrhosis...would show? early cirrhosis...not?
2) dr reading US see port hyper? not noted w/report
3) cyst R infer.lobe liver w/interseptation? Concerning/factor in liver, portal hyper?
4) ativan 1mg night to sleep,hurt liver? Or can I use Remeron 15 mg at nighttime instead/better sleep for me
5) Livatone Plus hurt liver? 4 x daily.
Havent drank for 8-9 yrs.
Any other comments?
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Thomas D Schiano, MDBlank
The Mount Sinai Medical Center
New York, NY
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