WBR0342

Author	[[PageAuthor::Serge Korjian (Reviewed by Yazan Daaboul, M.D. and Alison Leibowitz [1])]]
Exam Type	ExamType::USMLE Step 1
Main Category	MainCategory::Microbiology
Sub Category	SubCategory::Infectious Disease
Prompt	[[Prompt::Viral hepatitis is a prevalent infectious disease that is associated with significant worldwide morbidity and mortality. Despite being a relatively common disease, prognosis differs greatly and depends on the host immunity, viral type, and strain. Which of the following viral type and host combinations is associated with a high mortality rate?]]
Answer A	AnswerA::Hepatitis A among young children
Answer A Explanation	AnswerAExp::Hepatitis A among young children is often asymptomatic and rarely results in significant morbidity or mortality.
Answer B	AnswerB::Hepatitis B among elderly patients
Answer B Explanation	[[AnswerBExp::Hepatitis B among elderly patients manifests in the same manner as typical acute hepatitis B. However, chronicity is more common among elderly patients mainly due to failure of elderly patients to clear the disease as a result of impaired immunity.]]
Answer C	AnswerC::Hepatitis C among patients with cryoglobulinemia
Answer C Explanation	AnswerCExp::Hepatitis C in conjunction with cryoglobulinemia is not associated with an increase in the rate of infection-associated mortality.
Answer D	AnswerD::Hepatitis D among patients with acute hepatitis B
Answer D Explanation	[[AnswerDExp::Hepatitis D can only be acquired among patients with hepatitis B. Although hepatitis D is associated with an increase in mortality among patients with chronic hepatitis B and/or cirrhosis, it is not associated with an increase in the rate of mortality among patients with acute hepatitis B.]]
Answer E	AnswerE::Hepatitis E among pregnant women
Answer E Explanation	AnswerEExp::Although hepatitis E is usually a benign disease among the general population, it is associated with a high mortality rate (approximately up to 20%) among pregnant women.
Right Answer	RightAnswer::E
Explanation	[[Explanation::The Hepatitis E virus is a positive-sense single stranded RNA virus transmitted via fecal-oral route. Usually, it is a clinically benign disease that is often contracted in childhood and usually follows an asymptomatic or mildly symptomatic clinical course. Mortality rates are typically low, with the exception being among patients with severe liver failure. Among pregnant women infected with hepatitis E, mortality rates can be as high as 20%, particularly among women who contract the virus during their third trimester. Educational Objective: Hepatitis E is associated with an increased rate of mortality among pregnant women. References: Kumar A, Beniwal M, Kar P, et al. Hepatitis E in pregnancy. Int J Gynaecol Obstet. 2004;85(3):240-4. First Aid 2014 page 165]]
Approved	Approved::Yes
Keyword	WBRKeyword::Hepatitis E, WBRKeyword::Pregnant, WBRKeyword::Pregnancy, WBRKeyword::Women, WBRKeyword::Risk, WBRKeyword::Mortality rate
Linked Question	Linked::
Order in Linked Questions	LinkedOrder::