Case Study 2 - For Weekend

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17 Jul 2016 - General

Middle age gentleman, with background history of alcohol dependancy, previous peptic ulcer disease, epilepsy (not compliance to anti-epiletic medication), was admiited though emergency department due to Jaundice. His friend noted his skin colour turn yellow a few days ago, and eventually pursuade him to attend emergency department. He denied any abdominal/epigastric pain, denied chest pain, denied shortness of breath. He has been drinking heavily (with at least 20 unit alchol per day) for the last 3 weeks. He has no other symptoms, apart from Jaundice. Vitals (respiratory rate, blood pressure, oxygen saturation, pulse and temperature) are stable. Examination reveal hepatomegaly, sclera icterus, and obvious jaundice on the skin. Liver function showed elevated bilirubin, high INR, and low albumin level.  What will be your working diagnosis ?? What is the prognosis (what score can we used) ?? What is the management plan ?