his test is done to assess how well the liver is excreting Bilirubin by measuring it level and comparing it to the standard range. Bilirubin metabolism involves the breakdown of erythrocytes (haemoglobin), further processed in the liver tissues and excreted by the bile through the small intestines (Turgeon, 2007

INSTRUCTION
1. Each of the TESTS should be analysed with CITATION and Harvard style referencing at the end.
2. Each of the three QUESTION MUST BE ANSWERED.
3. MARKING CRITERIA must be followed.
4. Reason must be given for any differential Diagnosis
5. Please use MERCH MANUAL lab results for normal ranges.
6. It will be submitted via turnitin for Plagiarism purpose
Example of how each test should be analysed are as follows:
Bilirubin: This test is done to assess how well the liver is excreting Bilirubin by measuring it level and comparing it to the standard range. Bilirubin metabolism involves the breakdown of erythrocytes (haemoglobin), further processed in the liver tissues and excreted by the bile through the small intestines (Turgeon, 2007). High level of bilirubin suggests ineffective metabolism causing its deposition in the liver tissue unable to be processed, thus resulting in yellowing of the sclera and the skin as seen in the patient or development of jaundice (Turgeon, 2007).
Alkaline phosphatase – Any increase shows damage to the liver which is associated with the obstruction of the bile duct not able to transport the bile product from the liver. Normal range is 30-200 IU/L in a normal adult. (Burtis et al., 2008).
Gamma Glutamyl Transferase (GGT) – Further performed together with the Alkaline Phosphatase to confirm if the liver damage is due to bile ducts damage causing retention in liver leading to jaundice and potentially hepatic tumours. It can also help to confirm if a patient shows any clinical features of liver damage caused by alcohol. The normal range as the patient is a female is between 3-60 IU/L. (Palmer, 2004).
Serology test was requested to extensively investigate the abnormal results of the liver function tests and to further confirm exposure to infectious agents which can be any viral infection or bacterial infection in the blood serum and the test resulted in hepatises B viral infection (Marshall et al.,2008).In a healthy individual antibodies are not found in the blood unless there is an infection, therefore the serology helps to test for any antibodies which may help to lead on to the type of infection a patient may be suffering from. (Cuipe et al., 2007)
2. Possible diagnosis according to the laboratory test results in relation to the clinical features being shown by the patient suggest liver disease which is associated with hepatitis B infection (HBV) as the patient was tested positive.
Hepatises B virus is mostly associated with inflammation of the liver causing it to enlarge due to builds up of neutrophil ,lymphocytes and necrosis cells in the liver tissue (Iles et al.,2012). Hepatitis B virus affects the main tissues (hepatocytes) of the liver causing acute or chronic hepatitis B (Cuipe et al., 2007).
Marking Criteria

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