6™ YEAR OSCA, 1998 (ee FATIOR 2 HEFATINIS B EXAMINERS MARK SHEET INSTUCTIONS TO CANDIDATE: Mr. Smith is 4 30 year old man who presents to you with anorexia, nausea. vomiting malaise, fever. jaundice anda tender right upper quadrant. He has recent teen to South Eaet Asia an holiday die slmown LV dug weer. Puther hitory and oweminaion are unremarkable, ‘What is the most likely cause of his illness? SCORE CONDITION Hepatitis 2 2. FROMErT. if you suspected epulls Whuc Vest gATONS WOULG YOU OrGer? HbsAg 1 HCV DNA. 1 Anti HAV IgM. 1 LFT's 1 3.PROMPT: “ Here are the LFT’s. What do they indicate?” Elevated Bilirubin 0s AST Os ALT Os ALP Stighe unceane 03 Hepatitie picture ? (masimum 2) ‘PROMPT: ~ Here are the serology results. What do they indicate?” Acute or chronic hepatitis C 1 Chronic Hepatitis B t S.PROMPT: “ What advice will you give him with regards to transmission of the viruses? Safe sex 2 ‘Don’t share needles 1 6.PROMPT: “How will you treat his family?” ‘Test all or bsAg 2 + iffpositive- offer counselling 1 > if negative - vaccinate 1 7.COMMUNICATION SKILLS 3 TOTAL MARKS/20