Part 1
K.S. is a 35-year-old man who has been homeless for the past 5 years. He presents to the health department complaining of flulike symptoms and abdominal pain. K.S. has multiple tattoos and piercings. He admits to intravenous drug use and unprotected sexual behavior with multiple female partners. Blood tests reveal that K.S.’s liver enzymes are elevated. The healthcare provider suspects some type of hepatitis.
1. Considering K.S.’s lifestyle, which type or types of hepatitis has he most likely contracted? Explain your choice or choices.
Hepatitis A
Hepatitis B
Hepatitis C
2. How would you expect a differential diagnosis of hepatitis to be confirmed?
Presence of viral particles in stool
Elevated bilirubin and prothrombin time and low albumin
Presence of the specific hepatitis antibodies in the blood
Inflammation of the liver on ultrasound
3. Choose all of the following results that are consistent with an acute episode of hepatitis B infection. Discuss what each test measures.
Anti-HBs positive
Anti-HBc (IgM) positive
HBsAG positive
HBsAG negative
4. K.S.’s girlfriend is also developing similar symptoms. Which of the following factors likely explains the onset of the girlfriend’s symptoms?
They probably ate the same food.
They likely obtained the virus from contaminated water.
They probably infected each other through sexual contact or drug activity.
They likely became infected because of poor living conditions.
Part 2 – select three (3) clients (of your choosing) to assess
In which client cases would gastrointestinal cancer be a risk and what would be the likely type of cancer?
A 40-year-old man who smokes and has a duodenal ulcer.
A 50-year-old woman with long-standing GERD and recent evidence of Barrett esophagus on upper endoscopy.
A 60-year-old obese woman with a history of alcohol abuse and chronic pancreatitis.
A 25-year-old man who contracted hepatitis A on an international trip.
A 60-year-old woman with type 2 diabetes mellitus and a history of long-standing constipation and consuming one or two alcoholic drinks every other day.
A 25-year-old with a history of Hashimoto thyroiditis and Crohn disease.
