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Case 7

Gerry Gettings arrives for his yearly checkup. You see in his chart that about 8 months ago he had a serology positive case of hepatitis due to HBV. His hepatitis symptoms resolved in about 3 weeks and he mentions feeling fine now. See Gerry's History for vaccinations. Gerry's vital signs were all within normal range. Examination of all other systems appeared normal. You suggest that Gerry have some routine blood tests (e.g., cholesterol tests, glucose, Chem 7 panel).

Knowing Gerry's recent infection which of the following would help you determine how his liver is functioning?

    1. Alanine aminotransferase and aspartate aminotransferase
    2. Blood urea nitrogen and creatinine
    3. Blood carbon dioxide
    4. Troponins and creatinine phosphokinase
    5. Amylase
     

His liver enzymes were mildly elevated. To be on the safe side you ordered a hepatitis panel (see table below).

Test

Result

HBsAg

Negative

Anti-HBs

Positive

IgM for HBc

Negative

IgG for HBc

Positive

Which of the following best describes Gerry's current condition?

  1. Acute HBV infection
  2. Window period of HBV infection
  3. Convalescent HBV infection
  4. Chronic HBV infection

If Gerry's tests were the following then which of the following best describes his current condition?

Test

Result

HBsAg

Positive

Anti-HBs

Negative

IgM for HBc

Negative

IgG for HBc

Positive

  1. Acute HBV infection
  2. Window period of HBV infection
  3. Convalescent HBV infection
  4. Chronic HBV infection

Which of the following would have shown that Gerry's previous HBV vaccinations before and during medical school were protective (Gerry's History)?

  1. positive- HBsAg, positive-Anti-HBs, and positive-Anti-HBc
  2. negative- HBsAg, positive-Anti-HBs, and positive-Anti-HBc
  3. negative- HBsAg, negative-Anti-HBs, and positive-Anti-HBc
  4. negative- HBsAg, positive-Anti-HBs, and negative-Anti-HBc
  5. negative- HBsAg, negative-Anti-HBs, and negative-Anti-HBc

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Neal Chamberlain, PhD. A. T. Still University of Health Sciences/Kirksville College of Osteopathic Medicine.

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