Gary is a 21 year old Caucasian college student that was taken by a friend to the campus clinic. The friend
states, ”I’m really concerned about Gary. He was doing great in school, but got a little too involved in partying
and not eating right. Lately he has just been going to the salad bar at the corner deli. He hasn’t been feeling well
for a couple of days.You may want to check his eyes; they look kind of yellow to me.” The campus clinic PA is
able to evaluate Gary who reports general fatigue, muscle aches, loss of appetite, and nausea/vomiting with
abdominal pain. He also reports that his stools have been clay colored and his urine dark brown. Physical exam
is remarkable for low grade fever (99.9), yellow sclerae and skin, and mild right sided abdominal tenderness
without evidence of enlarged liver or spleen. Gary appears disheveled and tired. He states, ”I’m just really tired.
Can I get some pills to help me sleep and feel better ” The PA suspects Hepatitis A.