CASE STUDY Ruth, a 25 year office worker, decided to visit the doctor’s office after noticing changes in her body. She complained of severe nausea, vomiting, stomach pains and loss in appetite. But her biggest worries are her frequent skin itching, bloated belly and apparent yellowish pallor.  After physically examining Ruth, the doctor ordered several laboratory tests. These include CBC, Coagulation studies, blood chemistry and Serologic tests.  The results showed Prolonged Prothrombin time, increased INR, decreased blood proteins such as albumin, elevated liver enzymes and bilirubin levels. Her serology was reactive for the Hepatitis B surface antigen, positive for Total anti-HBc but negative for the anti-HBe and anti-HBs 1. What do you think caused the liver disease of Ruth? Explain your answer 2. What other hepatitis virus can infect Ruth? 3. Is it an acute or a chronic infection? Explain your answer

Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
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CASE STUDY

Ruth, a 25 year office worker, decided to visit the doctor’s office after noticing changes in her body. She complained of severe nausea, vomiting, stomach pains and loss in appetite. But her biggest worries are her frequent skin itching, bloated belly and apparent yellowish pallor.  After physically examining Ruth, the doctor ordered several laboratory tests. These include CBC, Coagulation studies, blood chemistry and Serologic tests.  The results showed Prolonged Prothrombin time, increased INR, decreased blood proteins such as albumin, elevated liver enzymes and bilirubin levels. Her serology was reactive for the Hepatitis B surface antigen, positive for Total anti-HBc but negative for the anti-HBe and anti-HBs

1. What do you think caused the liver disease of Ruth? Explain your answer
2. What other hepatitis virus can infect Ruth?
3. Is it an acute or a chronic infection? Explain your answer

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