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Author: Laurence Scott Bailen, M.D.

1. Question 1

A 34 year-old patient is admitted to the hospital for detox from intravenous drug use. A medical examination reveals marked elevations in the liver function tests. The total bilirubin is 3.4, AST 1,245, ALT 1,435, Alkaline phosphatase 85. The patient is diagnosed with hepatitis B.

Which of the following sets of serologic tests would you most likely find in this patient?

Hepatitis B surface antiguen

Hepatitis B surface antibody

Hepatitis B core IgM antibody

Hepatitis B e antigen

Hepatitis B e antibody

A

Negative

Positive

Negative

Negative

Negative

B

Negative

Negative

Positive

Negative

Negative

C

Positive

Negative

Negative

Positive

Negative

D

Positive

Negative

Positive

Positive

Negative

E

Positive

Positive

Positive

Negative

Negative

2. Question 2

A 45 year old man has a life insurance exam, and blood tests show a mildly elevated ALT of 65. His hepatitis C antibody is positive.

Which of the following most likely explains how he acquired hepatitis C?

  1. Blood transfusion in 2003

  2. Nasal cocaine use 25 years ago

  3. Intravenous drug use 25 years ago

  4. Unprotected sexual intercourse

  5. Ingesting contaminated shellfish

3. Question 3

A 28 year old physician has been vaccinated against hepatitis B.

Which of the following sets of serologies would you expect to see?

Hepatitis B surface antigen

Hepatitis B surface antibody

Hepatitis B core IgM antibody

Hepatitis B e antigen

Hepatitis B e antibody

A

Negative

Positive

Negative

Negative

Negative

B

Negative

Negative

Positive

Negative

Negative

C

Negative

Negative

Negative

Positive

Negative

D

Positive

Negative

Positive

Positive

Negative

E

Positive

Positive

Positive

Negative

Negative