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  #1  
Old 08-05-2011
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Liver Hepatitis B Infection; Likely Outcome!

29 year old with increases ALT and AST that has positive HBsAg. What is most likely outcome for the this patient:

a) complete resolution
b) fulminant hepatitis
c) stable chronic hepatitis
d) chronic hepatitis with progression to cirrhosis
e) chronic hepatitis with progression to hepatocellular carcinoma

Answer (highlight): A. Hep B causes all the above but the more than 95% of patients with Acute Hep B have complete resolution (UWorld).
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  #2  
Old 08-05-2011
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complete resolution , nearly all hep B patients resolve,
chronic hep will be with hep C
this is Uworld...
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  #3  
Old 08-05-2011
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Default

Quote:
Originally Posted by examtaker View Post
complete resolution , nearly all hep B patients resolve,
chronic hep will be with hep C
this is Uworld...
Complete resolution would require Anti-HBsAg right ?

I think it would be b) Fulminant hepatitis ..
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  #4  
Old 08-05-2011
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Quote:
Originally Posted by Hope2Pass View Post
Complete resolution would require Anti-HBsAg right ?

I think it would be b) Fulminant hepatitis ..
no the question says...most likely outcome...
hep B has >95% people = complete resolution
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  #5  
Old 08-05-2011
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A. complete resolution
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  #6  
Old 08-05-2011
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Default HepB and Possible Outcomes

Complete resolution. If my memory serves me right, I remember reading in Robbins that 70% of HepB infections are subclinical with complete resolution.
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  #7  
Old 07-06-2012
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Quote:
Originally Posted by norealname View Post
Complete resolution. If my memory serves me right, I remember reading in Robbins that 70% of HepB infections are subclinical with complete resolution.
You're right.
if it is chronic, it requires HBsAg +ve for at least 6 months. the question didnt mention any of these.
so, choices C, D and E can be crossed.
we left over with choice B. why it cannot be B?
Fulminant hepatitis is defined as acute liver failure with encephalopathy within 8 weeks of hepatic dysfunction decresed liver enzymes due to the destruction of liver parenchyma and hypocoagulopathy secondary to decreased hepatic synthetic function showing in low PT and high ammonia (altered urea cycle, contributes to the encephalopathy).

More than 90% of people attracted HBsAg recover. maximum 2% will develop chronic state, and less than 1% will have fulminant hepatitis. (the latter risk increase with coexistant Delta virus)

Hope these made things clear

Last edited by yoba; 07-06-2012 at 01:09 PM.
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  #8  
Old 07-06-2012
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Complete resolution.
Here are some useful trivia about all the hepatitides.
1. >90% of children with HAV infection are asymptomatic. Adults have a more severe presentation.
2. >90% of HBV infected people recover completely
3. >90% of vertically transmitted HBV leads to Chr HBV hepatitis
4. 80% of HCV infections are subclinical
5. >70% of HCV infections progress to chr hepatitis.
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  #9  
Old 07-08-2012
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resolution
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  #10  
Old 07-09-2012
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Default answer thiz

: A 24-year-old African-American female presents to the emergency room with fever, malaise, and intense pain over her right thigh. She has a long history of frequent presentation to the hospital with painful crises. Usually she is admitted and treated with supplemental oxygen and intravenous narcotics. This episode of pain is very different because she is febrile (103.0F) with exquisite tenderness over the right thigh, as well as local warmth. You send her for an MRI, and based on those results you wish to begin antibiotics promptly. Which of the following organisms is most likely causing her clinical presentation?



A. Salmonella
B. Escherichia
C. Klebsiella
D. Staphylococcus
E. Shigella
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  #11  
Old 07-09-2012
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Default A

Quote:
Originally Posted by bilal121 View Post
: A 24-year-old African-American female presents to the emergency room with fever, malaise, and intense pain over her right thigh. She has a long history of frequent presentation to the hospital with painful crises. Usually she is admitted and treated with supplemental oxygen and intravenous narcotics. This episode of pain is very different because she is febrile (103.0F) with exquisite tenderness over the right thigh, as well as local warmth. You send her for an MRI, and based on those results you wish to begin antibiotics promptly. Which of the following organisms is most likely causing her clinical presentation?



A. Salmonella
B. Escherichia
C. Klebsiella
D. Staphylococcus
E. Shigella

A- Salmonella.
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  #12  
Old 07-10-2012
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Default

A

Salmonella is the most common cause of osteomyelitis in SCD.
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  #13  
Old 07-12-2012
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Default answer thz

A 62-year-old Caucasian male who recently underwent a mitral valve replacement is having low-grade fevers. He also complains of dyspnea and malaise. Repeated blood cultures grow Gram-positive cocci in clusters that are catalase-positive and coagulase-negative. Which of the following is the best initial treatment for this patient?

A. Penicillin G
B. Nafcillin
C. Vancomycin
D. Ciprofloxacin
E. Erythromycin
F. Ceftriaxone
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  #14  
Old 07-12-2012
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Default C

Quote:
Originally Posted by bilal121 View Post
A 62-year-old Caucasian male who recently underwent a mitral valve replacement is having low-grade fevers. He also complains of dyspnea and malaise. Repeated blood cultures grow Gram-positive cocci in clusters that are catalase-positive and coagulase-negative. Which of the following is the best initial treatment for this patient?

A. Penicillin G
B. Nafcillin
C. Vancomycin
D. Ciprofloxacin
E. Erythromycin
F. Ceftriaxone

Would go with C
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  #15  
Old 07-14-2012
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Thumbs Up ...

Yoy are right my friend
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  #16  
Old 07-14-2012
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Default UW

hep b complete resolution
hep C chronic active hep
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  #17  
Old 07-14-2012
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Default sickle

salmonella is common with sickle cell
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  #18  
Old 07-14-2012
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Default coagulase negative

it is vancomycin...

a similar q in uw , the typcial answer is vancomycin, with or without rifampin and gentamycin
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  #19  
Old 07-15-2012
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You are right boy
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