USMLE Forum Archives - USMLE Step 2 CK - IM 20
IM 20
TheOne - 12-06-06 11:41
A 60-year-old man comes to his physician for a consultation. The patient is concerned that he may have gotten some "disease" from blood. He has read in the newspapers and seen on TV that people who get blood transfusions can get "diseases," and he received a transfusion in the eightys. The patient has been a patient in this office for a few years, and his only other past medical history is hypercholesterolemia and hypertension, for which he is being treated with pravastatin and hydrochlorothiazide. He has no abdominal pain, fever, night sweats, or jaundice. Which of the following is the most appropriate screening test?
A. Hepatitis B
B. Hepatitis C
C. HIV
D. PPD skin testing
E. Rapid plasma reagin testing
TheOne - 12-06-06 11:41
A 60-year-old man comes to his physician for a consultation. The patient is concerned that he may have gotten some "disease" from blood. He has read in the newspapers and seen on TV that people who get blood transfusions can get "diseases," and he received a transfusion in the eightys. The patient has been a patient in this office for a few years, and his only other past medical history is hypercholesterolemia and hypertension, for which he is being treated with pravastatin and hydrochlorothiazide. He has no abdominal pain, fever, night sweats, or jaundice. Which of the following is the most appropriate screening test?
A. Hepatitis B
B. Hepatitis C
C. HIV
D. PPD skin testing
E. Rapid plasma reagin testing
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#1
Re: IM 20 drs_kh - 12-07-06 03:24 I think correct answer is A, because risk of Hepatitis B virus transmission due to transfusion is more than the rest.
#3
Re: IM 20 Brainlab - 12-08-06 14:14 Correct answer is B.
Hepatitis C. The hepatitis C virus is the most likely cause of hepatitis after a blood transfu-
sion. Although blood is now screened for hepatitis B and C, the hepatitis C test was developed
later. Hepatitis C also is more likely than hepatitis B to progress to chronic hepatitis, cirrhosis,
and cancer.
#4
Re: IM 20
TheOne - 12-11-06 11:36 The correct answer is C. It is generally accepted that the blood supply from 1978 to 1985 was likely to be tainted with HIV positive blood. For this reason, as well as the indolent nature of HIV infection, patients with a history of blood transfusions during these years, even if currently asymptomatic, should be screened.
Testing for hepatitis B (choice A) or hepatitis C (choice B) would not be incorrect, but there are no formal guidelines recommending this. The primary reason is that such diseases generally manifest in some way after a 20-year period, and the patient would not be asymptomatic.
PPD skin testing (choice D) is reserved for health care workers, alcoholics, IV drug abusers, diabetics, and end-stage renal patients. This does not change with a history of blood transfusion.
RPR, or rapid plasma reagin testing (choice E), is used to test for syphilis. It is recommended if the patient is pregnant, has a history of sexual transmitted diseases, or is a prostitute.
#6
Re: IM 20 babbu5508 - 07-08-10 01:13 A. Hepatitis B...
because hiv would have manifested by now...and hepatitis can be aymptomatic and go unnoticed for years....
#8
Re: IM 20 bingousmle - 07-09-10 01:11 he should be checked for hepatitis c as it has the largest risk of transmission through blood transfusion among all the other things listed..
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