Review Questions

1. A 28-year-old intravenous drug user comes to the physician because of a 1-week history of weakness, fatigue, and extreme nausea. He says that he typically uses his own needles to inject drugs, but "money was tight" four months ago, and he had been "forced" to share needles with friends. He has not shared a needle in the past 2 months. Physical examination shows scleral icterus, jaundiced skin, and right upper quadrant abdominal tenderness. Laboratory studies show markedly elevated levels of alanine aminotransferase and aspartate aminotransferase. The diagnosis is suspected to be viral hepatitis. Which of the following markers is most likely to be positive at this stage of the disease?

Anti-HAV IgG HBcAb IgG HBsAb IgG HBsAg

2. An 18-year-old boy is brought to the physician by his mother because of "uncontrollable shaking" of his right hand. The mother says that she is also concerned about some "bizarre behavior" lately. Physical examination shows a resting tremor and golden deposits on his corneas. Laboratory studies are most likely to show which of the following results?

A. Elevated serum iron

B. Decreased urinary copper excretion

C. Decreased serum ceruloplasmin

D. Decreased serum ferritin

E. Decreased tissue copper levels

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