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A 35-year-old male clinical laboratory scientist complained of chronic fatigue. After visiting his family physician, he was diagnosed with iron deficiency anemia and given a prescription for iron supplements. However, his fatigue continued with nausea and aching of the joints, particularly the ankles and wrists. He remembered performing some patient serum testing without wearing gloves about three months earlier. His co-worker noticed a slight yellowing of the sclera and decided to test his liver enzymes with the following results.
          AST        1782 U/L
          ALT        2498 U/L
          ALP        172 U/L
          GGT        79 U/L
1.    What is the most likely preliminary diagnosis (general)?

2.    What additional tests should be performed to aid in the differential diagnosis?


3.    Describe the time course of elevation of the serological markers for Hepatitis B.

4.    The patient tested positive for HBsAg. Based on this value, what is the most likely final diagnosis?


5.    Why is the ALT value greater than AST?

6.    Why is ALP only slightly elevated?


7.    Would the bilirubin value be expected to be elevated? If so, which fraction would be most predominantly elevated?

8.    How is Hepatitis B transmitted?
 


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RSCH8110 Research Theory Design and Methods

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