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A 36-year-old female presents to the clinic with a 10-day history of flu-like symptoms, including anorexia and malaise. She does not report any pertinent prior medical history or surgeries. She takes no medications. Her family history is noncontributory, and she reports no sick contacts. She reports of having multiple partners in the last decade and has used oral contraceptives regularly for the past 12 years. She also reveals of having used IV drugs occasionally in the past few years. She has not traveled outside Canada in the past 5 years. On physical examination, she is alert and oriented, in no acute distress. Her vital signs are temperature of 99.9°F, pulse 78/minute, respirations of 18/minute, and blood pressure of 121/78 mm Hg. Mild scleral icterus is noted. Heart sounds are regular rate and rhythm without murmurs, and lungs are clear to auscultation bilaterally. The abdomen is soft and nontender, except the liver is tender when palpated and extends 8 cm below the costal margin, with a smooth edge. Initial laboratory testing show the following: Marker Values Reference range Alanine aminotransferase (ALT) 3817 U/L 7-55 U/L Aspartate aminotransferase (AST) 2152 U/L 8-48 U/L Alkaline phosphatase (ALP) 176 U/L 45-115 U/L Albumin 3.4
SCIENCE
HEALTH SCIENCE
NURSING
HLSC 2461U