A 27 year old man develops bilateral parotid gland swelling and orchitis, and is generally ill with fever of 102deg F. Which of the following substances is most likely to be significantly elevated in the patient’s serum?
**Core Concept**
The patient's symptoms suggest an infection caused by a specific type of microorganism that targets the salivary glands and male reproductive organs. This clinical presentation is characteristic of mumps, a viral infection caused by the mumps virus.
**Why the Correct Answer is Right**
The mumps virus primarily targets the exocrine glands, including the salivary glands, pancreas, and testes. Elevated amylase levels are a hallmark of mumps infection due to the virus's effect on the parotid glands, which produce saliva containing amylase. Amylase is an enzyme that breaks down starches into sugars. In mumps, the parotid glands become inflamed, leading to an increase in amylase levels in the serum. This is a specific and sensitive indicator of mumps infection.
**Why Each Wrong Option is Incorrect**
**Option A:** Alanine aminotransferase (ALT) is an enzyme primarily found in the liver and is often elevated in liver diseases such as hepatitis. While liver enzymes may be elevated in some viral infections, ALT is not specifically associated with mumps.
**Option C:** Aspartate aminotransferase (AST) is another liver enzyme that may be elevated in liver diseases. Like ALT, AST is not specifically associated with mumps infection.
**Option D:** Ceruloplasmin is a copper-carrying protein in the blood that is often elevated in Wilson's disease, a genetic disorder affecting copper metabolism. Ceruloplasmin levels are not directly related to mumps infection.
**Clinical Pearl / High-Yield Fact**
Mumps virus can cause a range of systemic symptoms, including fever, headache, and muscle aches, in addition to the characteristic parotid gland swelling. It is essential to consider mumps in the differential diagnosis of patients presenting with these symptoms, particularly in the context of outbreaks or in individuals who have not received the mumps vaccine.
**✓ Correct Answer: B. Amylase**