A 34 year old is brought by her husband to the casualty department with acute confusion.

Question Number 0635

Question:
A 34 year old is brought by her husband to the casualty department with acute confusion. He describes that they have recently had their first baby and everything had gone fine. Both mother and baby were doing fine one week post delivery. He had found his wife lying on the living-room floor on arrival home from work. On examination the woman appears slightly jaundiced. Examinations reveal that her creatinine is slightly raised and that her transaminase is elevated to about 9,000 IU/L. What would the next investigation of choice be?

a) anti-mitochondrial antibodies
b) urinary magnesium levels
c) salicylate levels
d) paracetomol levels
e) look for lytic lesions on plain radiographs


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