HEPATITS A ——S ‘A45y.0 woman who retumed recently from a 2 week holiday from India, develpoed fever, rigors and sweats. The next stage she developed nausea. anorexia and right upper quadrant pain. Whilst in India she ctayed ina local hotel and even lacal food and water ‘What are the likely diagnosis? Viral Hepatitis - Hepatitis A most likely, 10 Malaria 10 Dengue os ‘What 2 tests do you think are the most important? rE 10 LT 10 ‘Comment on the LFT results provided. ‘All LFT results raised except protein and albumin Os Marked rise in AST mand ALT 03 ALT>> AST os Hepatitic picture ~ most likely due to viral infection 10 ‘What other tests are indicated at this point of time. ABUi-HAV 10 Tneag os ‘Ani-HCV Os ‘Thick and Thin fim 05 ‘The test comes back 1 week tater and shows she is Hep-A positive. She returns to you eager to know ber results, Tell the patieat the diagnosis and managemeat. ‘She has been infected by a virus called Hepatitis-A which affects the liver. OS ‘Contracted by ttansmission - probably by the food in India Os ‘Hep A responshle for her symptoms 0s She is clear o, ner serious viral hepatitis Os Sel-umining condition ~ she is noc a camer or wati be chronscatry infected, 03 However she is still at risk of spreading the virus 0s Will make a complete recovery os Dat may vonplain uf Uebility fin sevesal sav after eavlitive Uf inital xpmpwomn, 0.3 Management ‘Mo epecific treatment LO ‘Good hygiene is important as can still transmit virus, 0s Avoid alcohol for a few weeks. Os Advice an seeking medical advion haface newt trip as Follow-up Os One vear later she returns for advice reeardine another trin to india. What will vou do? Hepatitis. A vaccine-or immunoglobulin is an option- ¢ 6/52 before trip ) 0.5 Water - boil the water. avoid ice, preferably use bottled water os Food — sou pecoamly ced food Oa ona tee oe ee eee 05 Other hygiene measures - wash hands Os Prophylaxis of other infectious diseases — malarial prophylaxis. 05 ‘Rapport Lo TOTAL MARK mm