WBR0342

Author	[[PageAuthor::Rim Halaby, M.D. [1], Alison Leibowitz [2] (Reviewed by Alison Leibowitz)]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Microbiology
Sub Category	SubCategory::Infectious Disease
Prompt	[[Prompt::Viral hepatitis is a major infectious cause of morbidity and mortality worldwide, and despite being a relatively common disease, prognosis differs greatly depending on the host, viral type, and strain. Which of the following combinations is associated with a high mortality rate?]]
Answer A	AnswerA::Hepatitis A in young children
Answer A Explanation	AnswerAExp::Hepatitis A in young children is often asymptomatic and rarely is associated with increased risks of morbidity and mortality.
Answer B	AnswerB::Hepatitis B in elderly patients
Answer B Explanation	AnswerBExp::Hepatitis B in elderly patients manifests in the same manner as typical acute hepatitis B, except chronicity is more common in elderly patients as a result of their impaired immunity.
Answer C	AnswerC::Hepatitis C in patients with cryoglobulinemia
Answer C Explanation	AnswerCExp::Hepatitis C in conjunction with cryoglobulinemia does not increase the mortality rate.
Answer D	AnswerD::Hepatitis D in patients with acute Hepatitis B
Answer D Explanation	[[AnswerDExp::Hepatitis D can only be acquired in the context of Hepatitis B. Although, hepatitis D increases mortality in patients with chronic hepatitis B and/or cirrhosis, it usually does not increase the rate of mortality in patients with acute hepatitis B.]]
Answer E	AnswerE::Hepatitis E in pregnant women
Answer E Explanation	AnswerEExp::Hepatitis E is associated with high mortality in pregnant women of up to 20%, although it is a benign often asymptomatic disease in the general population.
Right Answer	RightAnswer::E
Explanation	[[Explanation::The Hepatitis E virus, a positive-sense single stranded RNA virus transmitted via fecal-oral route, is a clinically benign disease often contracted in childhood and usually asymptomatic. Mortality rates are typically low, with the exception being patients with severe liver failure. In pregnant women infected with hepatitis E, mortality rates can be as high as 20%, particularly in women who contract the virus during their third trimester. Educational Objective: Hepatitis E is associated with increased mortality in pregnant women. References: Kumar A, Beniwal M, Kar P, Sharma JB, Murthy NS. Hepatitis E in pregnancy. Int J Gynaecol Obstet. 2004;85(3):240-4.]]
Approved	Approved::Yes
Keyword	WBRKeyword::Hepatitis E, WBRKeyword::pregnant, WBRKeyword::pregnancy, WBRKeyword::Hepatitis, WBRKeyword::mortality
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::