QBDOTW: A hepatitis panel is ordered for a 25-year-old woman as part of a routine work-up for abdominal pain
Welcome back to MedSmarter’s USMLE Style Question of the Week. Here’s the breakdown of another high-yield GI Immunology question for those preparing for your USMLE Step 1 or just to gain some knowledge. As always you want to begin by reading the last sentence of the vignette first to get an understanding of what the question is asking for.
Question Break Down of the Week:
A hepatitis panel is ordered for a 25-year-old woman as part of a routine work-up for abdominal pain. Results of serologic testing are negative for HBeAg and HBsAg, but positive for HBsAb and IgG HBcAb. Which of the following is the appropriate conclusion?
(A) The patient has been exposed to hepatitis B but was never infected
(B) The patient has been exposed to hepatitis B and has completely recovered
(C) The patient has been exposed to hepatitis B and is in the acute disease phase
(D) The patient has been exposed to hepatitis B and is in the window phase
(E) The patient has not been exposed to hepatitis B
The correct answer choice is B. The patient has been exposed to hepatitis B and has completely recovered. This is because the patient tested negative for both HBeAg and HBsAg, which rules out the acute disease phase and carrier state. However, the patient tested positive for HBsAb, indicating exposure to hepatitis B, and IgG HBcAb, indicating past infection and recovery. The presence of IgG HBcAb suggests that the patient is in the completely recovered phase, rather than the window phase, as IgM HBcAb would be present in the latter. Therefore, option (B) is the most appropriate conclusion.
Did you think the answer was different?
Did you think that the correct answer choice was other than B? You can view this video for a deeper discussion of why A, C, D, and E are not the correct answer choices.
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