Communicable diseases: hepatitis E: practice question

A PSM question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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PSM · Communicable diseases: hepatitis E

Sample item

After flooding in a village, many adults develop jaundice about 5 weeks later. A woman at 32 weeks of pregnancy has deep jaundice, bleeding and confusion. Which infection is the most likely, and what is its recognised risk in such a woman?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Hepatitis E, with a high risk of fulminant liver failure in late pregnancy

Hepatitis E is a faecal-oral, waterborne infection that causes epidemics after contamination of water supplies, with an incubation of about 2 to 8 weeks. Mortality is much higher in pregnant women, especially in the third trimester, because of fulminant hepatic failure. There is no chronic carrier state in immunocompetent people.

Option by option

  • A. Hepatitis A, with a high risk of chronic hepatitis

    Hepatitis A is waterborne but does not become chronic and is not especially severe in pregnancy.

  • B. Hepatitis B, with a high risk of an epidemic waterborne spread

    Hepatitis B spreads by blood, sexual and perinatal routes rather than as a waterborne epidemic.

  • C. Hepatitis E, with a high risk of fulminant liver failure in late pregnancy (correct)

    Correct. HEV causes waterborne epidemics and severe disease in late pregnancy.

  • D. Hepatitis C, with a high risk of fulminant failure in the first trimester

    Hepatitis C is bloodborne and does not cause waterborne outbreaks or typical fulminant failure.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More PSM questions

Questions about this PSM question

What is the answer to this PSM question?

The best answer is C, Hepatitis E, with a high risk of fulminant liver failure in late pregnancy. Hepatitis E is a faecal-oral, waterborne infection that causes epidemics after contamination of water supplies, with an incubation of about 2 to 8 weeks.

Why is "Hepatitis A, with a high risk of chronic hepatitis" not the answer?

Hepatitis A is waterborne but does not become chronic and is not especially severe in pregnancy.

Why is "Hepatitis B, with a high risk of an epidemic waterborne spread" not the answer?

Hepatitis B spreads by blood, sexual and perinatal routes rather than as a waterborne epidemic.

Why is "Hepatitis C, with a high risk of fulminant failure in the first trime…" not the answer?

Hepatitis C is bloodborne and does not cause waterborne outbreaks or typical fulminant failure.

What concept does this question test?

It tests Communicable diseases: hepatitis E in PSM. Mortality is much higher in pregnant women, especially in the third trimester, because of fulminant hepatic failure. There is no chronic carrier state in immunocompetent people.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Communicable diseases: hepatitis E?

Practise biostatistics with small calculations until sensitivity, predictive values and risk measures are automatic. Then use the flashcards and the other PSM questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.