Gastrointestinal (interpretation)

Question 1

Interpret the following Hepatitis B serology

Answer 1

HBsAg +ve: current infection
Anti-HBs -ve: no immunity
HBeAg +ve: current infection
Anti-HBe -ve: No immunity
Anti-HBc IgM +ve: recent/current infection
Anti-HBc IgG -ve: infection is current and is not resolved or chronic
HBV DNA +ve: poor prognostic factor for progression

Dx: Acute hepatitis B infection

Question 2

Interpret the following Hepatitis B serology

Answer 2

HBsAg +ve: current infection
Anti-HBs -ve: no immunity
HBeAg +ve: current infection
Anti-HBe -ve: No immunity
Anti-HBc IgM -ve: previous/chronic infection
Anti-HBc IgG +ve: infection is resolved/chronic
HBV DNA +ve: poor prognostic factor for progression

Dx: Chronic active hepatitis B infection

Question 3

Interpret the following Hepatitis B serology

Answer 3

HBsAg +ve: current infection
Anti-HBs -ve: no immunity
HBeAg -ve: no current infection
Anti-HBe +ve: natural immunity, inactive carrier state
Anti-HBc IgM -ve: previous/chronic infection
Anti-HBc IgG +ve: infection is resolved/chronic
HBV DNA +ve: poor prognostic factor for progression

Dx: Chronic hepatitis B infection (inactive, carrier)

Question 4

Interpret the following Hepatitis B serology

Answer 4

HBsAg -ve: no current infection
Anti-HBs +ve: immunity
HBeAg -ve: no current infection
Anti-HBe +ve: immunity from previous infection
Anti-HBc IgM -ve: previous/chronic infection
Anti-HBc IgG +ve: infection is resolved/chronic
HBV DNA -ve

Dx: Immunity following acute infection

Question 5

Interpret the following Hepatitis B serology

Answer 5

HBsAg -ve: no current infection
Anti-HBs +ve: immunity
HBeAg -ve: no current infection
Anti-HBe -ve: no immunity from previous infection
Anti-HBc IgM -ve: no current infection
Anti-HBc IgG -ve: no previous infection
HBV DNA -ve

Dx: Immunity following vaccination

Question 6

A 38-year-old presents with right upper quadrant abdominal pain. They drink 3-4 bottles of vodka a week

Interpret the following LFT

Answer 6

Bilirubin elevated
AST elevated
ALP slightly elevated
AST:ALP ration is >2
ALT elevated
GGT slightly elevated

Dx: Alcoholic hepatitis

Question 7

A 38-year-old presents with right upper quadrant abdominal pain. Interpret the following LFT

Answer 7

Bilirubin elevated
AST elevated
ALP significantly elevated
ALT slightly elevated
GGT elevated

Dx: Ascending cholangitis (triad of symptoms: fever, jaundice and RUQ pain as well as cholestatic LFTs)

Question 8

A 44-year-old man presents with a 6-week history of right upper quadrant pain and malaise. He has had multiple sexual partners with inconsistent barrier protection use. He did not receive his childhood vaccines

Interpret the following LFT

Answer 8

Bilirubin elevated
AST elevated over 5x the upper limit
ALT elevated over 5x the upper limit
ALT > AST suggests hepatocellular injury
ALP within normal limits
GGT mildly elevated, non-specifc marker of liver injuruy

Dx: Acute hepatitis - most likely viral (hepatitis A/B or C) given the history

Question 9

A 50-year-old woman presents for an annual checkup. She has a PMH of diabetes and hypertension. Her BMI is 43 kg/m2

Interpret the following LFT

Answer 9

Bilirubin normal
AST elevated
ALT elevated
ALP slightly elevated
GGT normal

Dx: Non-alcoholic fatty liver disease/hepatic steatosis

Dx: Acute hepatitis - most likely viral (hepatitis A/B or C) given the history

Question 10

Answer 10

Bilirubin, AST, ALT all deranged
ALP and GGT increased
Normal albumin

Dx: Gallstones

Question 11

Answer 11

Dx: PBC

Question 12

Answer 12

AST>ALT + normal albumin
No sign of LFT obstruction – NORMAL GGT and ALP
But liver damage – LOW ALBUMIN

Dx: Acute hepatitis