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The activity "Red Light, Yellow Light, Green Light: The Art and Science of Treatment Decision-Making in Patients with HBV" is currently unavailable.
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The educational activity, Red Light, Yellow Light, Green Light: The Art and Science of Treatment Decision-Making in Patients with HBV, is available on 12/14/2018.
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CASE 1 (Mrs. Ling)
ML is a 28-year-old Chinese woman who comes to you for evaluation of chronic hepatitis B (CHB). She was diagnosed with CHB during college and was told that she was a “carrier.” She is 12 weeks into her first pregnancy. She has no symptoms except mild morning sickness. Her mother has CHB, and she has no family history of cirrhosis or hepatocellular carcinoma. Her labs are as follows:
All of the following are appropriate for management at this initial visit except:
ML’s lab results indicate the following:
Based on these results, what phase of CHB is the patient in?
ML presents to you at week 30 of pregnancy feeling well, but she is concerned about transmission of CHB to her baby. An ultrasound of her liver at week 14 was normal, and labs from week 28 revealed the following:
All of the following are appropriate management recommendations at this time except:
CASE 2 (Mr. Jones)
FJ is a 62-year-old white male, Vietnam war veteran presents with abnormal liver enzymes. He feels tired. He has a history significant for hypertension, diabetes mellitus (on oral medications), and obesity. He has no family history of cirrhosis or hepatocellular carcinoma, but a history of alcoholism in his paternal uncle and grandfather. He is retired from working as a longshoreman and is married with two children. He is a former smoker. He drinks a “beer or two” a day. His current medications are metformin and lisinopril. His physical exam reveals a BMI of 37, few spider angiomata on chest wall, and hepatomegaly. His labs are notable for:
Based on these results, what phase of CHB is Mr. Jones in?
You order a liver ultrasound for FJ, and it reveals a slightly enlarged liver with echogenicity and mild nodularity. The report suggests the possibility of fibrosis/cirrhosis and steatosis, but no hepatic lesions or vascular thrombosis. A transient elastography is also obtained and is interpreted as the patient having stage 4 fibrosis ~ cirrhosis. Which of the following is not appropriate for management at this point?
CASE 3 (Mrs. Tran)
Patient ST is a 62-year-old Vietnamese woman with CHB who presents to establish care in your office.
She has a history of hypertension for which she is taking hydrochlorothiazide. Her mother has CHB, but she has no family history of cirrhosis or hepatocellular carcinoma. Her physical exam is normal, and her BMI is 23. Her labs reveal the following:
You decide to start ST on 0.5 mg qd entecavir. She returns 1 year later with the following results:
All of the following are appropriate next steps in her management except to:
IN-001-121418-47 PRE-TEST
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Red Light, Yellow Light, Green Light: The Art and Science of Treatment Decision-Making in Patients with HBV
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