Your patient is a 23-year-old male prisoner who is alert and oriented, complaining of general malaise. He describes a month-long history of weakness, joint pain, nausea and occasional vomiting, and anorexia. He has no medical history and takes no medications. Physical examination reveals clear lung sounds bilaterally; warm, dry skin; several prison tattoos; a firm liver; and jaundice to his sclera. Which of the following is most likely?

Question

Quizplus · Accepted Answer

The patient's history of jaundice to the sclera, along with the symptoms of weakness, joint pain, nausea, and anorexia, suggest a liver issue. Given his young age, lack of medical history, and clear lung sounds, cirrhosis is less likely. Fatty liver may be a possibility, but the presence of jaundice is more suggestive of an acute liver disease such as hepatitis B. The patient's history as a prisoner makes him at higher risk for blood-borne infections such as hepatitis B, increasing the likelihood of this diagnosis. HIV is a possibility, but it is less likely given the absence of other symptoms typically seen with HIV infection.

Your Patient Is a 23-Year-Old Male Prisoner Who Is Alert