A 2-year-old participant in a day-care center is the third child over a several-week period to develop fever, nausea and vomiting, jaundice, and dark urine. As the physician consultant to the day-care center, you develop a fact sheet for other families, explaining which of the following about the virus likely to be the etiology of these problems?
a. It has a long incubation period (50 to 80 days)
b. It causes clinical symptoms to develop after a prolonged viremic stage
c. It causes disease that usually is more severe in adults than children
d. It is spread by parenteral route
e. It causes elevations of liver function studies and serum bilirubin levels for 6 months or more
the answer is below…
The United States Medical Licensing Examination, or USMLE for short, is a three-part licensing examination that is required in order to receive a license to practice medicine within the United States.
The USMLE assesses a physician’s ability to apply knowledge, concepts, and principles, and to determine fundamental patient-centered skills that are important in health and disease and that constitute the basis of safe and effective patient care.Examination committees composed of medical educators and clinicians from across the United States and its territories prepare the examination materials each year.
This exam is designed by the Federation of State Medical Boards and the National Board of Medical Examiners to determine whether or not an individual understands and can apply the knowledge necessary to practice medicine safely and intelligently.
The USMLE is actually comprised of three different exams that are referred to as steps, which examine the individual’s knowledge of specific topics related to the field of medicine such as basic science, medical knowledge, medical skills, clinical science, and the application of all of these skills and areas of knowledge in the medical field.
All three steps of the USMLE include a series of computerized multiple-choice questions, but the format of the exam and the information covered in each multiple-choice section is different for each step of the USMLE. The USMLE Step II also has a clinical skills portion that examines an individual’s ability to work with real patients and the USMLE Step III has a computerized patient simulation portion in addition to the multiple-choice section of the exam. In order for an individual to receive a license to practice medicine, the individual must pass all three steps of the USMLE.
The correct answer is c; It causes disease that usually is more severe in adults than children.
The children in the question likely have hepatitis A (infectious hepatitis); this disease is characterized by a relatively short incubation period (15 to 50 days) following transmission of the virus, which is primarily by the fecal-oral route. Its onset is abrupt, with sudden fever, nausea, vomiting, anorexia, and tenderness of the liver, soon followed by jaundice. Subclinical infections are common. Elevated serum levels of bilirubin and aspartate aminotransferase (serum glutamic-oxaloacetic transaminase, SGOT) are transient, usually not persisting for more than 3 weeks. Viremia is brief, and the period of maximum infectivity of stools usually occurs during the 2 weeks prior to the onset of jaundice. Disease is usually more severe in adults than in children; many children are asymptomatic. Hepatitis A vaccination is available, and post-exposure prophylaxis with immunoglobin is also possible.