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Question
R.J., a 25-year-old single video store clerk, comes to the outpatient clinic because he has been feeling ill for the last week or two and today he noticed that his eyes appeared yellow and his urine was dark. He reports an aversion to food, and if he eats, he frequently vomits. He has some discomfort in his right upper abdomen as well as headaches and aches in his joints. He says that he is just sick all over and feels exhausted. When questioned about his past medical history he says he has been healthy and does not use any medications. His alcohol use includes "a beer or two" almost every evening. He denies smoking or illicit drug use but does report that he and his girlfriend with whom he is sexually active visited Mexico a couple of months ago and she used and injected street drugs while they were there. She had the flu about a month ago but is feeling fine now.
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