Tutorial 11th. September 2023

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47	Role-play.                            Topic disclosed during the tutorial
48	Structured conversation. Topic disclosed during the tutorial
49	EMQ. Hepatitis D
50	EMQ. Hepatitis E

 

47.         Role-play.

Candidate’s instructions.

You are the SpR in the antenatal clinic. Jenny Brown has been booked in her second pregnancy by the midwife. She has some questions about (*** topic revealed during the tutorial so that you can’t do any preparation!), which affected her first child, now 6 years old. The midwife who did the booking does not feel able to provide adequate answers and has asked you to see the patient.

 

48.         Structured conversation.

The examiner will ask a series of questions – topic revealed during the tutorial.

 

49.         EMQ. Hepatitis D. Hepatitis Delta.

Abbreviations:

HBsAg:  hepatitis B surface antigen

HBsAb: antibody to hepatitis B surface antigen

HBV:     hepatitis B virus

HCsAg:  hepatitis C surface antigen

HDV:     hepatitis D virus; hepatitis delta virus

HEsAg:  hepatitis E surface antigen

Question. Which, if any, of the following statements are true in relation to HDV? This is not a true EMQ as there may be >1 correct answer.

Option list.

A	HDV is a large DNA virus
B	HDV is a defective virus
C	HDV gains entry to human cells via the HDV receptor
D	HDV gains entry to human cells by donning a disguise and using the HBV receptor
E	HDV only flourishes when HBsAb is present
F	HDV only flourishes when HBsAg is present
G	coinfection is when HDV and another viral infection are present at the same time
H	Susu superinfection is when HDV is present in abnormally high numbers
I	HDV infection is the least serious of the viral hepatitides in relation to pregnancy
J	HDV treatment was revolutionised by analysis of the benefits of drinking bleach as suggested by Donald Trump
K	the   WHO has recommended that those who follow medical advice from Donald trump should be categorised as ‘having the DTs’.
L	HDV needs the presence of HBsAg to be a significant pathogen
M	HDV needs the presence of HCsAg to be a significant pathogen
N	HDV needs the presence of HEsAg to be a significant pathogen
O	pegylated interferon alpha is highly effective as treatment
P	mother-to-child transmission is mainly via the placenta
Q	WHO recommends tenofovir prophylaxis from 28 weeks in pregnancy in HDV infected women
R	the   infected neonate should be given HDV vaccine

 

50.         EMQ. Hepatitis E.

These are not true EMQs as there may be more 1 correct answer.

Question 1. What is the most common cause of acute viral hepatitis in the UK?

Option list.

A	hepatitis A virus
B	hepatitis B virus
C	hepatitis C virus
D	hepatitis D virus
E	hepatitis E virus
F	herpes simplex virus
G	HIV

Question 2. Which, if any, of the following are correct about HEV.

Option list.

A	it is a DNA virus
B	it belongs to the genus Hippieviridae
C	it belongs to the genus Hepeviridae
D	it belongs to the genus Hoppieviridae
E	there are six main genotypes
F	genotype 3 is the one of greatest importance in the UK
G	the main reservoir of genotype 3 is intensively-reared chickens
H	the main reservoir of genotype 3 is domestic cats
I	a vaccine exists but is only licensed in Russia
J	none of the above

Question 3. Which, if any, of the following statements about HEV and pregnancy are true?

Option list.

A	pregnant women are more susceptible to HEV infection
B	pregnant women are more likely to develop serious disease that the non-pregnant
C	the main risk is neonatal death due to vertical transmission
D	the main risk is maternal death
E	the risk of maternal death is highest with infection in the 1st. trimester
F	↑ rates of preterm birth have been reported
G	↑ rates of stillbirth have been reported