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NBME 23 Answers

nbme23/Block 2/Question#6 (38.6 difficulty score)
A 6-month-old girl is brought to the office ...
Hepatitis B🔍

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submitted by chris07(55),
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hTe lony einnfoict on thta ltis atht oyu doulw enev rsecen na eoewihtrs aelthhy agrenpapi niuivdilad si heT osrhet I uwodl htnki yuo oyln chekc if the tinpeta sha a tnonieaspert ahtt smeak uyo usesptc tm,he ikel VBE fi ehty dah isgns of ,noom ro SRV if yeht had arotsiyrpre pymtsso.m At htat ti,nop theye'r no ognler ecignnres ttse,s ubt mreo gnctsdiioa .ones

gilbert  I got it right because I thought of the prevalance of HBV in China. +5  

submitted by sympathetikey(1349),
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cLyku ,idecuntdo ubt oikgonl bk,ac I eebliev ahtw hyet erew niggo rfo is what she sduloh vhae ebne ctvcadeina rof ta 6 nshmto fo gea ie(scn eterh rea on atrnppea psosmy.m)t

Hpe B avcecni si suylalu eving ta ih,tbr 1 mhont, dan 6 tnohsm of e,ga so 'tis pryett rpianttom that she be dvenactiac tganisa ti, nsusel she yelrdaa hsa i,t ni iwhhc seac ehs udlsho be tertead ot iaodv issoh.rric

ls3076  how can we actually be expected to know vaccination schedules... there must be some other reason the answer is correct +4  
cbreland  I don't think we need to know that the vaccination schedules, but that the only other answer with a vaccine was adenovirus. I figured that there would have more symptoms if she had adenovirus (plus didn't fit the typical military recruit/swimmer demographic) +  
koko  Why does it have to be something with a vaccine? RSV Is extremely common in babies,shouldn’t screen for that? +  

submitted by goodkarmaonly(0),
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iDrsodres mnoocm ni stea Aasi rcnigcoda to aHl: toiGnesatpji B EVB oifintecn - soylmt gnailde ot lagnaesnoayrhp hA ClaAp ilirNemamnstaai haessoT ekndil alnttiInse peyt cisatgr CA

In hits qou,tnies nceis eht tapntei is oitampsmcyat and EVB sint talcyex eecnrde"s ,fr"o etwn htwi BeHp as eht serwan

ls3076  i think asymptomatic is really the key here -- good catch +2  

submitted by usmle11a(74),
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eht hdlci is piysaomtatmc ecaubes hpesitiat B si ysolmt linets ni nsinfat edu ot poro tycolemhpy mtyss.e other dieesass odlwu lobaprby hows moer pmsmtsoy

submitted by nukie404(8),
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oT mus it ,pu vnee fi uoy d'dtni zieremom het ewohl onimmiunizta balt,e 'tsi yesa ot brrmemee VHB mnaiuizntoim si noed ta hr,bti 1om, o2m and mo6 .rohgylu sAol ddead taht teh bbay si of Etsa nisaA dn,teec nad teh atfc ttha ehort fcnsieoitn no hte itls ra'etn endserec fro in hte ftirs lpace in a-ntgiheoyhkllo aepistt,n I ihnkt is't asfe ot edudec VHB wsa hte erwnsa eehr.

submitted by avicenna(2),

Good research to read over Hep-B being prevalent in china!

submitted by drzed(217),

Of all these viruses, Hep B is the only one that a child, if infected, would be a chronic carrier. Thus we should screen to make sure that we can prevent future risk of cirrhosis, etc.

submitted by bilirrubin15(0),

I thought Hepatitis B has high prevalence in developing countries, she is from a rural region from China, I got right. Plus Hepatitis B is asymptomatic in new borns.