MRCP2-1800

MRCP2-1800

A 32-year-old woman presents to the Emergency Department with symptoms of a GI upset and increasing dull abdominal pain. She is worried because she has become jaundiced. She has a history of occasional cocaine use in college but denies any illicit drug use currently. Prior to her recent trip to Mexico, she received a vaccination against hepatitis A. On examination, she has tenderness in the right upper quadrant. Which infection is the most likely diagnosis?

Investigations:
– Haemoglobin (Hb): 130 g/l (normal value: 115-155 g/l)
– White cell count (WCC): 11.3 × 109/l (normal value: 4-11 × 109/l)
– Platelets (PLT): 201 × 109/l (normal value: 150-400 × 109/l)
– Sodium (Na+): 138 mmol/l (normal value: 135-145 mmol/l)
– Potassium (K+): 3.4 mmol/l (normal value: 3.5-5.0 mmol/l)
– Creatinine (Cr): 112 µmol/l (normal value: 50-120 µmol/l)
– Alanine aminotransferase (ALT): 1821 IU/l (normal value: 5-30 IU/l)
– Alkaline phosphatase (ALP): 203 IU/l (normal value: 30-130 IU/l)
– Albumin: 35 g/l (normal value: 35-55 g/l)
– Prothrombin time (PT): 13.2 s (normal value: 10.6-14.9 s)