Week 6 - A young woman with jaundice Flashcards
What extra questions would you like to ask this young woman?
What preliminary investigations would you perform on this patient?
What are the important points in the history for each of the causes of hepatitis?
Interpret these blood results. What other investigations should be performed?
What is the diagnosis (A, B, C, D or E)?
- A. Previous infection with hepatitis B (HBV)?
- B. Chronic HBV?
- C. Acute hepatitis C (HCV?
- D. Acute HBV?
- E. Chronic HCV?
- These tests suggest a ‘hepatic’ cause for her jaundice with predominant elevation of her transaminases (ALT and AST). The only true markers of liver function are the bilirubin, prothrombin time (INR) and albumin.
- She has a thrombocytosis which is likely to represent an acute-phase reaction.
- Lymphocytosis and the presence of atypical lymphocytes raise the possibility of viral infection.
How would you manage this patient with an acute HBV infection?
- A. Commence antiviral medications
- B. Start an infusion fo N-acetylcysteine?
- C. Start HBV immunoglobulin?
- D. Consider interferon therapy?
- E. Ensure good hydration and nutrition?
How would you interpret these results?