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Hepatitis B exam questions for medical finals, OSCEs and MRCP PACES

Click on the plus symbols for answers to these questions on about Hep B

Question 1.

How does Hepatitis B present?

  • Hep B often presents with a subclinical or flu-like illness but can present with:
  • Acute hepatitis
    • Hepatomegaly
    • Jaundice (only 30-50%)
    • Dark urine/pale stools due to intrahepatic cholestasis
  • Serum-sickness-like syndrome
    • Rash, polyarthritis, fever
  • Rarely, arteritis or immune-complex-mediated renal failure
  • Chronic liver disease
    • Either compensated or decompensated (see CLD pages)

Question 2.

What are the treatment options for chronic hepatitis B?

  • Pegylated interferon
    • Good:
      • No resistance
      • Finite duration of therapy
    • Bad:
      • Less well tolerated due to side-effect profile
      • Only moderate antiviral activity
  • Nucleoside (Lamivudine, Entecavir) and Nucleotide (Tenofovir) analogues
    • Good:
      • Potent antiviral effects
      • Few side-effects
    • Bad:
      • Risk of resistance with some drugs

Question 3.

What are the complications of hepatitis B?

  • Fulminant hepatitis from acute infection
  • Chronic infection which can lead to chronic liver disease, cirrhosis and its complications including HCC (see decompensated CLD page)

 

Click here for the diagnosis and management of Hepatitis B

Common Hepatitis B exam questions for medical students, finals, OSCEs and MRCP PACES

…and click here to learn about Hep B serology