Hepatitis B Quiz: Ace Your Exams
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A 35-year-old man is brought to the emergency department by EMS after his partner found him at home lethargic and confused. His partner states that over the last week, he has been easily agitated, forgetting simple tasks, and sleeping during the day. He told his partner he was feeling nauseous. His partner states he has a substance use disorder and uses IV drugs. He has no significant medical history. Temperature is 37.0°C (98.6°F), pulse is 90/min, respirations are 22/min, and blood pressure is 118/80 mmHg. On exam, he is somnolent but arousable to sound and is able to follow commands. Eye exam shows scleral icterus without papilledema and with a normal pupillary exam Abdominal tenderness is present in the right upper quadrant. Flapping is noted when he extends his arms and cocks his hands back. Head CT is normal and toxicology screen is negative. Lab results are shown below. Which of the following is the most appropriate next step in management?
| Laboratory value | Result |
| AST | 967 units/L |
| ALT | 1,132 units/L |
| Total bilirubin | 7.3 mg/dL |
| INR | 1.9 |
| Anti-HBc IgM | + |
| HBsAg | - |
| HBsAb | - |
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