Acute Hepatitis B
GNUR543
St. John Fisher College

Mr. Wilson is a 47 year old man being evaluated for complaints of fatigue, anorexia and abdominal distention. On examination, it is noted that the skin is jaundiced and the liver enlarged. D.W. denies significant alcohol or drug use. He denies any known exposure to hepatitis and has never been vaccinated for hepatitis. He is taking no medication. Laboratory tests reveal the following and a diagnosis of acute hepatitis B is made:

1. Review and analyze the laboratory data. What diagnosis is supported by these values? Give your rationale.
Mr. Wilson’s lab work is reviewed below: * AST 142 IU/L * AST (Aspartate aminotransferase) is an enzyme and blood sample results
It can also bridge to central veins, confluent necrosis (Mani & Kleiner, 2009). This leads to scarring, the creation of fibrous strands and in many cases will lead to fibrosis. Throughout the liver cells are becoming damaged therefore blocking and limiting the livers functionality. Hormone secretion, chemicals and toxins in the blood, clotting factors and other defense fighting macrophages are interrupted (Copstead, 2010). Along with the inflammation, the patient will feel fatigued and will have a lowered immunity. * Ascites and peripheral edema: Abdominal distention, ascites, is a result of the damaged cells within the liver and more specifically the membrane of the cell has been damaged. There is an intra-abdominal buildup of sodium, water and protein. The cells in the liver are unable to maintain the appropriate osmotic gradient across the pleura (Copstead, 2010). This extra fluid is likely to accumulate in the dependant areas of a person’s body, such as ankles, legs, and arms (Kukka, 2010). * Jaundice: Red blood cells have a short life span and as they die and/or are damaged the body will break them down and dispose of them. This is referred to as bilirubin metabolism and this happens in three phases; pre, intra and posthepatic. (Copstead, 2010). The red blood cells should be broken down, delivered to the liver and then transported through the biliary system and thus be