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. 

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  • Hepatitis A
  • Hepatitis B
  • Hepatitis C

2. How would you expect a differential diagnosis of hepatitis to be confirmed? 

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  • 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. 

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  • 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? 

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  • 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.