USMLE CK Quiz # 5
USMLE Step 2 Examination;
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1. Question
A 38-year-old man who works as a reporter for a travel magazine comes to his physician because of the acute onset of jaundice, malaise, and temperatures to 38.5 C (101 F). He had returned from Burma 2 weeks ago, where he spent 4 weeks. He says that he abstains from alcohol beverages and does not take any medications. Laboratory studies show elevated serum aminotransferases, high bilirubin (both total and direct), and negative serology for hepatitis A virus (HAV) and C virus (HCV) infection. He was vaccinated for hepatitis B virus (HBV) 3 years ago and is now positive for anti-HBsAg antibodies. Which of the following serologic markers should be tested as the most appropriate next step in diagnosis?
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Answer & Rationale:
Option B is correct answer
The correct answer is C. Hepatitis E virus (HEV) is rare in the U.S., but outbreaks of acute hepatitis E occur in some countries, namely Mexico, India, Afghanistan, and Burma. The infectious agent is transmitted by the oralfecal route, usually from infected water. HEV hepatitis is generally self-limited, but it is important to note that it carries a 10% to 20% mortality rate in pregnant women. Similar to HAV, HEV infection does not cause chronic hepatitis or a carrier state. The onset of IgM antibodies to HEV is concomitant with the appearance of clinical symptomatology, whereas IgG will become detectable after the acute phase.
Incorrect
Answer & Rationale:
Option B is correct answer
The correct answer is C. Hepatitis E virus (HEV) is rare in the U.S., but outbreaks of acute hepatitis E occur in some countries, namely Mexico, India, Afghanistan, and Burma. The infectious agent is transmitted by the oralfecal route, usually from infected water. HEV hepatitis is generally self-limited, but it is important to note that it carries a 10% to 20% mortality rate in pregnant women. Similar to HAV, HEV infection does not cause chronic hepatitis or a carrier state. The onset of IgM antibodies to HEV is concomitant with the appearance of clinical symptomatology, whereas IgG will become detectable after the acute phase.
