7. CIS Clinical Approach to Pt with Elevated Liver Enzymes

Question 1

50 F presents with jaundice, diffuse pruritus, fatigue, smokes 1PPD, yellow skin and sclera, with yellow patches on the inside corners of her eyes… what would be most likely found serologically?

Answer 1

Anti-Mitochondrial Antibody (primary biliary cirrhosis)

cholestatic pattern predominates

Question 2

If everything is normal and there is an elevated unconjugated bilirubin on testing, what is expected?

Answer 2

Gilbert’s Syndrome

Question 3

What does a low haptoglobin signal?

Answer 3

Hemolysis or hemolytic anemia

Question 4

What type of HBV does the serology suggest?

HBsAG+, HBsAb-, HBcAb IgG+, HBeAg+

Answer 4

Chronic HBV, replicating

Question 5

What type of HBV does the serology suggest?

HBsAG+, HBsAb-, HBcAb IgM+, HBeAg+

Answer 5

Acute HBV, replicating

Question 6

What type of HBV does the serology suggest?

HBsAg-, HBsAb+, HBcAb IgG-, HBcAb IgM-, HBeAg-

Answer 6

Vaccinated- only have Ab against

Question 7

What type of HBV does the serology suggest?

Anti-HAV IgG

Answer 7

Prior HepA

Question 8

What type of HBV does the serology suggest?

Anti-HCV Ab+, HCV RNA-

Answer 8

Prior HCV

Question 9

What type of HBV does the serology suggest?

HBsAg-, HBsAb-, HBcAb IgM+, HBeAg-, HBVDNA-

Answer 9

Window period*** during acute hepatitisB

Question 10

What type of HBV does the serology suggest?

HBsAg-, HBsAb+, HBcAb IgG+, HBeAg-, HBVDNA-

Answer 10

Previously affected, but cleared the virus