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?

Alanine aminotransferase and aspartate aminotransferase
Blood urea nitrogen and creatinine
Blood carbon dioxide
Troponins and creatinine phosphokinase
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?

Acute HBV infection
Window period of HBV infection
Convalescent HBV infection
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

Acute HBV infection
Window period of HBV infection
Convalescent HBV infection
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)?

positive- HBsAg, positive-Anti-HBs, and positive-Anti-HBc
negative- HBsAg, positive-Anti-HBs, and positive-Anti-HBc
negative- HBsAg, negative-Anti-HBs, and positive-Anti-HBc
negative- HBsAg, positive-Anti-HBs, and negative-Anti-HBc
negative- HBsAg, negative-Anti-HBs, and negative-Anti-HBc

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