26malik
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A 35-year-old man presents to his doctor with loss of appetite, nausea and vomiting, and fatigue. Laboratory examination confirms the diagnosis of hepatitis B, and the man becomes icteric 2 weeks later. This patient may also be particularly vulnerable to the development of which of the following disorders?
A. Berry aneurysm
B. Coronary artery aneurysm
C. Dissecting aneurysm
D. Giant cell arteritis
E. Polyarteritis nodosa
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| doc179
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E
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| robin082006
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EEEE
Edited by robin082006 on 05/25/06 - 06:43 AM
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| Slacker
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E. But i don't exactly understand why the patient develops icterus. Can someone plz explain???
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| robin082006
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intrahepatic bile obstruction
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| mitty
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I thought it is the unconjugated bilirubin that is high in viral hepatitis.so how come it is intrahepatic bile obstraction? p.s robin explain this to me.
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| rebmd
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intrahepatic bile obstruction= unconjugated bilirubin, b/c the bilirubin cannot enter the liver to be conjugated due to the bile ducts IN THE LIVER being obstructed. perhaps you are confused between intrahepatic and extrahepatic obstruction. extrahepatic obstruction (i.e. when the bile is passing out of the liver).
note, that with intrahepatic obstruction, you may have some conjugated bilirubin, b/c some of the bilirubin can enter to be conjugated, but it cannot exit the liver.
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| mitty
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thank you rebmd.
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| 26malik
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The correct answer is E.
Thirty percent of patients with polyarteritis nodosa have hepatitis B antigenemia. Polyarteritis is a systemic necrotizing vasculitis that can be difficult to diagnose, since the vascular involvement is typically widely scattered, and the specific symptoms depend on the specific vessels (small- to medium-sized arteries) involved. Patients typically present with low-grade fever, weakness, and weight loss. Abdominal pain, hematuria, renal failure, hypertension, and leukocytosis may occur. The disease is frequently fatal if untreated.
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