Patient case: Hepatitis
A 45-year-old woman presents to her primary care physician with a two-week history of fatigue, nausea, and a yellowish tint to her skin and eyes. She reports mild upper right abdominal discomfort, especially after eating. She denies any recent travel but mentions that she had been drinking alcohol more frequently over the past few months due to personal stress.
Her medical history is notable for high blood pressure, managed with medication. She has no known history of liver disease or risk factors for hepatitis, but she did have a blood transfusion five years ago following an accident. She denies any drug use or unprotected sex.
On examination, the patient is alert but appears tired. Her skin shows mild jaundice, and scleral icterus is also present. The abdomen is soft, but there is mild tenderness in the right upper quadrant. No palpable masses are felt.
Laboratory results reveal elevated liver enzymes: ALT (Alanine Aminotransferase) of 120 U/L, AST (Aspartate Aminotransferase) of 105 U/L, and bilirubin of 3 mg/dL. Hepatitis B and C serology tests are pending.
The patient is advised to avoid alcohol and is referred to a gastroenterologist for further evaluation. The physician discusses the possibility of viral hepatitis and explains the importance of further testing for hepatitis A, B, and C.
A) Hepatitis A
B) Hepatitis B
C) Hepatitis C
D) Alcoholic liver disease
A) Family history of liver disease
B) Blood transfusion five years ago
C) Recent use of over-the-counter medications
D) History of travel to an endemic area
A) Immediate initiation of antiviral therapy
B) Liver biopsy
C) Avoid alcohol and monitor liver enzymes
D) Start corticosteroid therapy
A) Normal ALT and AST levels
B) Elevated liver enzymes (ALT, AST), elevated bilirubin
C) Elevated WBC count and low hemoglobin
D) Low platelets and elevated ESR
