De-identified Question
{
"question": "47-year-old male with cirrhosis. What laboratory tests and medications should be ordered? [DATE] Sodium: 137 Potassium: 3.7 Chloride: 107 Carbon Dioxide: 21 (L) Anion Gap: 9 Blood Urea Nitrogen (BUN): 3 (L) Creatinine: 0.69 BUN/Creatinine Ratio: 4 (L) Estimated Glomerular Filtration Rate: 116 Glucose: 99 Calcium: 8.2 (L) Alkaline Phosphatase: 145 (H) Albumin: 2.6 (L) Globulin, Calculated: 6.3 Albumin/Globulin Ratio: 0.4 Protein, Total: 8.9 (H) Aspartate Aminotransferase (AST): 86 (H) Alanine Aminotransferase (ALT): 25 Bilirubin, Total: 3.3 (H) White Blood Cell Count: 4.1 (L) Red Blood Cell Count: 4.37 (L) Hemoglobin: 14.9 Hematocrit: 43.7 MCV: 100.0 (H) MCH: 34.1 MCHC: 34.1 RDW: 14.6 Platelet Count: 75 (L) MPV: 10.7 SEGMENTED NEUTROPHILS: 81.0 LYMPHOCYTES: 10.0 MONOCYTES: 8.0 Eosinophils: 1.0 Segmented Neutrophils, Absolute: 3.32 Absolute Neutrophil Count: 3.32 ABSOLUTE LYMPHOCYTES: 0.41 (L) Monocytes, Absolute: 0.33 Eosinophils, Absolute: 0.04 Platelet Estimate: Decreased Prothrombin Time (PT): 20.4 (H) International Normalized Ratio (INR): 1.7 (H) Smooth Muscle Antibody: Negative Alpha Fetoprotein (Tumor Marker): 5.08 [DATE] Sodium: 133 (L) Potassium: 3.7 Chloride: 104 Carbon Dioxide: 21 (L) Anion Gap: 8 Blood Urea Nitrogen (BUN): 3 (L) Creatinine: 0.62 BUN/Creatinine Ratio: 5 (L) Estimated Glomerular Filtration Rate: 119 Glucose: 98 Calcium: 7.6 (L) Alkaline Phosphatase: 126 Albumin: 2.4 (L) Globulin, Calculated: 6.8 (H) Albumin/Globulin Ratio: 0.4 (L) Protein, Total: 9.2 (H) Aspartate Aminotransferase (AST): 70 (H) Alanine Aminotransferase (ALT): 17 Bilirubin, Direct: 2.10 (H) Bilirubin, Total: 4.3 (H) Troponin I: <0.01 Ammonia: 24 Lipase: 46 White Blood Cell Count: 3.7 (L) Red Blood Cell Count: 4.25 (L) Hemoglobin: 14.8 Hematocrit: 43.8 MCV: 103.1 (H) MCH: 34.8 (H) MCHC: 33.8 RDW: 14.0 Platelet Count: 67 (L) MPV: 10.2 SEGMENTED NEUTROPHILS: 81.0 Bands: 1.0 LYMPHOCYTES: 11.0 MONOCYTES: 5.0 Eosinophils: 2.0 Segmented Neutrophils, Absolute: 3.00 Absolute Neutrophil Count: 3.03 ABSOLUTE LYMPHOCYTES: 0.41 (L) Monocytes, Absolute: 0.19 Eosinophils, Absolute: 0.07 Large Platelets: Present Macrocytosis: Slight Platelet Estimate: Decreased Prothrombin Time (PT): 22.5 (H) International Normalized Ratio (INR): 1.9 (H) Partial Thromboplastin Time, Activated (aPTT): 41.7 (H) Ethanol: 138 (H) [DATE] Sodium: 136 Potassium: 3.9 Chloride: 104 Carbon Dioxide: 23 Anion Gap: 9 Blood Urea Nitrogen (BUN): 4 (L) Creatinine: 0.64 BUN/Creatinine Ratio: 6 (L) Estimated Glomerular Filtration Rate: 118 Glucose: 98 Calcium: 8.1 (L) Alkaline Phosphatase: 134 (H) Albumin: 2.4 (L) Globulin, Calculated: 6.8 Albumin/Globulin Ratio: 0.4 Protein, Total: 9.2 (H) Aspartate Aminotransferase (AST): 64 (H) Alanine Aminotransferase (ALT): 17 Bilirubin, Total: 4.8 (H) Cholesterol, Total: 130 Triglycerides: 122 HDL Cholesterol: 32 (L) LDL Cholesterol: 74 Non-HDL Cholesterol: 98 Cholesterol/HDL Ratio: 4.1 Hemoglobin A1c (POC): 4.7 Estimated Average Glucose: 88 Thyroid Stimulating Hormone: 3.700 T4 (Thyroxine), Free: 1.06 [DATE] Sodium: 137 Potassium: 4.1 Chloride: 105 Carbon Dioxide: 26 Anion Gap: 6 Blood Urea Nitrogen (BUN): 4 (L) Creatinine: 0.70 BUN/Creatinine Ratio: 6 (L) Estimated Glomerular Filtration Rate: 115 Glucose: 106 (H) Calcium: 8.3 (L) [DATE] EGD Lumens: Report available [DATE] US Abdomen Complete: Report available [DATE] Sodium: 134 (L) Potassium: 4.5 Chloride: 103 Carbon Dioxide: 21 (L) Anion Gap: 10 Blood Urea Nitrogen (BUN): 13 Creatinine: 1.34 (H) Creatinine Change (%): 91.43 (H) BUN/Creatinine Ratio: 10 Estimated Glomerular Filtration Rate: 66 Glucose: 95 Calcium: 8.3 (L) Alkaline Phosphatase: 116 Albumin: 2.4 (L) Globulin, Calculated: 5.9 Albumin/Globulin Ratio: 0.4 Protein, Total: 8.3 Aspartate Aminotransferase (AST): 43 Alanine Aminotransferase (ALT): 16 Bilirubin, Total: 3.6 (H) White Blood Cell Count: 4.2 (L) Red Blood Cell Count: 3.17 (L) Hemoglobin: 10.5 (L) Hemoglobin Change (g/dL): -4.30 (L) Hematocrit: 31.2 (L) Hematocrit Change (%): -12.60 (L) MCV: 98.4 MCH: 33.1 MCHC: 33.7 RDW: 13.7 Platelet Count: 108 (L) MPV: 10.1 SEGMENTED NEUTROPHILS: 76.0 LYMPHOCYTES: 6.0 MONOCYTES: 14.0 Eosinophils: 4.0 Segmented Neutrophils, Absolute: 3.19 Absolute Neutrophil Count: 3.19 ABSOLUTE LYMPHOCYTES: 0.25 (L) Monocytes, Absolute: 0.59 Eosinophils, Absolute: 0.17 Platelet Estimate: Decreased Prothrombin Time (PT): 23.2 (H) International Normalized Ratio (INR): 2.0 (H) Alpha Fetoprotein (Tumor Marker): 5.59 PEth 16:0/18:1 (POPEth): 62 PEth 16:0/18:2 (PLPEth): 46 Interpretation, PEth: See Comment EER Phosphatidylethanol (Ext): See Note [DATE] Albumin, Peritoneal Fluid (Ext): 0.3 Source, Protein, Body Fluid: Peritoneum Protein, Body Fluid: 0.9 Volume, Body Fluid: 6 Color, Body Fluid: Yellow Appearance, Body Fluid: Clear Neutrophils, Body Fluid: 6 Lymphocytes, Body Fluid: 8 Macrophages, Body Fluid: 29 Monocytes-Histiocytes, Body Fluid: 37 Mesothelial Cells, Body Fluid: 20 Red Blood Cells, Body Fluid: <2,000 Total Nucleated Cells, Body Fluid: 87 Culture, Body Fluid: Report available [DATE] IR Paracentesis w Imaging: Report available [DATE] Sodium: 129 (L) Potassium: 3.8 Chloride: 98 Carbon Dioxide: 21 (L) Anion Gap: 10 Blood Urea Nitrogen (BUN): 17 Creatinine: 1.66 (H) BUN/Creatinine Ratio: 10 Estimated Glomerular Filtration Rate: 51 (L) Glucose: 89 Calcium: 8.4 (L) Alkaline Phosphatase: 130 (H) Albumin: 2.7 (L) Globulin, Calculated: 6.1 Albumin/Globulin Ratio: 0.4 Protein, Total: 8.8 (H) Aspartate Aminotransferase (AST): 40 Alanine Aminotransferase (ALT): 16 Bilirubin, Total: 3.4 (H) [DATE] Prothrombin Time (PT): 22.6 (H) International Normalized Ratio (INR): 1.9 (H) [DATE] CV TransTHORACIC Echo 2D Complete: Report available LVEF BP: 64 LV EDV INDEX BP: 55 LVIDD: 4.5 AV VMAX: 1.5 AV MEAN PG: 4 AVA CONT. VTI: 2.7 AVA CONT. VMAX: 2.8 LVOT DIAM: 2.1 MV MEAN PG: 2 TAPSE: 2.3 DIMENSIONLESS INDEX: 0.77 PVEIN A REV VEL: 0.2 [DATE] IR Paracentesis w Imaging: Report available [DATE] Sodium: 126 (L) Potassium: 4.0 Chloride: 96 (L) Carbon Dioxide: 18 (L) Anion Gap: 12 Blood Urea Nitrogen (BUN): 38 (H) Creatinine: 2.13 (H) BUN/Creatinine Ratio: 18 Estimated Glomerular Filtration Rate: 38 (L) Glucose: 102 (H) Calcium: 8.5 (L) Alkaline Phosphatase: 87 Albumin: 2.6 (L) Globulin, Calculated: 5.8 Albumin/Globulin Ratio: 0.4 Protein, Total: 8.4 (H) Aspartate Aminotransferase (AST): 40 Alanine Aminotransferase (ALT): 18 Bilirubin, Total: 3.6 (H) Prothrombin Time (PT): 23.6 (H) International Normalized Ratio (INR): 2.0 (H) [DATE] Sodium: 130 (L) Potassium: 4.2 Chloride: 99 Carbon Dioxide: 20 (L) Anion Gap: 11 Blood Urea Nitrogen (BUN): 36 (H) Creatinine: 2.14 (H) BUN/Creatinine Ratio: 17 Estimated Glomerular Filtration Rate: 37 (L) Glucose: 95 Calcium: 8.6 Magnesium: 2.8 (H) Alkaline Phosphatase: 115 Albumin: 2.7 (L) Globulin, Calculated: 6.4 (H) Albumin/Globulin Ratio: 0.4 (L) Protein, Total: 9.1 (H) Aspartate Aminotransferase (AST): 44 Alanine Aminotransferase (ALT): 19 Bilirubin, Total: 3.2 (H) NT-PRO BNP: 324 (H) Lipase: 79 (H) White Blood Cell Count: 4.6 Red Blood Cell Count: 3.39 (L) Hemoglobin: 11.0 (L) Hematocrit: 31.8 (L) MCV: 93.8 MCH: 32.4 MCHC: 34.6 RDW: 14.9 Platelet Count: 110 (L) MPV: 9.5 SEGMENTED NEUTROPHILS: 83.0 LYMPHOCYTES: 10.0 MONOCYTES: 5.0 Eosinophils: 2.0 Segmented Neutrophils, Absolute: 3.82 Absolute Neutrophil Count: 3.82 ABSOLUTE LYMPHOCYTES: 0.46 (L) Monocytes, Absolute: 0.23 Eosinophils, Absolute: 0.09 Platelet Estimate: Decreased Prothrombin Time (PT): 21.7 (H) International Normalized Ratio (INR): 1.9 (H) (L): Data is abnormally low (H): Data is abnormally high"
}