{"id":4743,"date":"2024-11-20T00:01:00","date_gmt":"2024-11-20T00:01:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=4743"},"modified":"2025-10-01T11:38:23","modified_gmt":"2025-10-01T19:38:23","slug":"usmle-step-1-question-of-the-day-viral-hepatitis","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-viral-hepatitis","title":{"rendered":"USMLE\u00ae Step 1 Question of the Day:\u00a0Viral hepatitis"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_86 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-viral-hepatitis\/#The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\" >The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-viral-hepatitis\/#Incorrect_Answer_Explanations\" >Incorrect Answer Explanations<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-viral-hepatitis\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-viral-hepatitis\/#Major_Takeaway\" >Major Takeaway\u00a0<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-viral-hepatitis\/#Want_to_learn_more_about_this_topic\" >Want to learn more about this topic?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-viral-hepatitis\/#References\" >References\u00a0<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><em><strong>Prepare for the USMLE Step 1 exam with this detailed question about a 28-year-old woman experiencing severe abdominal pain and jaundice after returning from a trip to Southeast Asia. What family of viruses causes patchy necrosis of the liver? Test your knowledge and deepen your understanding of viral infections.<\/strong><\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 28-year-old Gravida 1 para 0 woman presents to the emergency department due to severe abdominal pain and jaundice. The patient&#8217;s symptoms started one week ago after returning from a trip to Southeast Asia. The patient\u2019s partner had mild fatigue and jaundice but is currently improving. Initial bloodwork from the patient shows markedly elevated bilirubin and transaminases. The patient is admitted to the intensive care unit but eventually develops fulminant liver failure and dies. Autopsy shows patchy necrosis of the liver, and the cause of liver damage is determined to be viral hepatitis. The virus causing this patient\u2019s hepatitis most likely belongs to which of the following viral families?&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Hepevirus<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Hepadna virus<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Picornavirus<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Flavivirus<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">E. Delta virus<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\">Scroll down for the correct answer!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_USMLE%C2%AE_Step_1_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s USMLE\u00ae Step 1 Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Hepevirus<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the Main Explanation, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_Answer_Explanations\"><\/span>Incorrect Answer Explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Hepadna virus<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect: <\/strong>Hepatitis B virus is a Hepadnavirus. This patient\u2019s condition is most likely caused by hepatitis E, a Hepevirus.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Picornavirus<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Hepatitis A virus is a Picornavirus. This patient\u2019s condition is most likely caused by hepatitis E, a Hepevirus.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Flavivirus<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Hepatitis C virus is a Flavivirus. It does not cause acute hepatitis. This patient\u2019s condition is most likely caused by hepatitis E, a Hepevirus.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Delta virus<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Incorrect:<\/strong> Hepatitis D virus is a Deltavirus that causes hepatitis in patients with coexisting hepatitis B. This patient\u2019s condition is most likely caused by hepatitis E, a Hepevirus.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">This pregnant woman developed fulminant liver failure due to viral hepatitis. The patient\u2019s partner probably also had the virus but only developed the mild disease. Given the travel history, the most likely cause is the hepatitis E virus. The Hepatitis E virus causes acute hepatitis similar to hepatitis A and is usually mild and resolves spontaneously. However, Hepatitis E can lead to devastating events in pregnant women, including fulminant hepatic failure, miscarriage, and stillbirth. Hepatitis E virus is transmitted via the fecal-oral route and is endemic in some areas in Africa, Southeast Asia, and the Middle East. It should be suspected in patients with hepatitis who have traveled to endemic areas recently.&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hepatitis E virus is an RNA virus that belongs to the <strong>Hepevirus <\/strong>family. It is a nonenveloped virus with an icosahedral capsid.&nbsp;&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The other hepatitis viruses belong to different families and are as follows:&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hepatitis A virus is a Picornavirus&nbsp;<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hepatitis B virus is a Hepadnavirus&nbsp;<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hepatitis C virus is a Flavivirus&nbsp;&nbsp;<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hepatitis D virus is a deltavirus&nbsp;<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"624\" height=\"340\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/10\/image_39080b.png\" alt=\"HEPATITIS A &amp; E\n- RNA Viruses\n- Transmitted by fecal-oral route\n- Acute hepatitis\n- Immune system destroys infected cells\n\nSymptoms\n- Fever\n- Fatigue\n- Loss of appetite\n- Nausea\n- Vomiting\n- Abdominal pain\n- Dark urine and pale stools\n- Jaundice\n\n* Hepatitis E is especially dangerous\nTreatment: Supportive, dietary\nPrevention: Hepatitis A\n- Immune serum globulin\" class=\"wp-image-4744\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/10\/image_39080b.png 624w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/10\/image_39080b.png?resize=300,163 300w\" sizes=\"auto, (max-width: 624px) 100vw, 624px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway\u00a0<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Hepatitis E virus is an RNA virus that belongs to the Hepevirus family. It can lead to mild hepatitis in immunocompetent individuals but can have devastating effects on pregnant women (e.g., fulminant hepatitis).&nbsp;&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Want_to_learn_more_about_this_topic\"><\/span>Want to learn more about this topic?<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Watch the Osmosis video:<\/strong> <strong><a href=\"https:\/\/www.osmosis.org\/learn\/Viral_hepatitis:_Pathology_review\">Viral hepatitis: Pathology review<\/a><\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"References\"><\/span>References\u00a0<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Waqar, S., Sharma, B., Koirala, J. Hepatitis e. [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK532278\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK532278\/<\/a>&nbsp;<\/li>\n\n\n\n<li>Kamar, N., Dalton, H. R., Abravanel, F., &amp; Izopet, J. (2014). Hepatitis E virus infection. <em>Clinical microbiology reviews<\/em>, <em>27<\/em>(1), 116\u2013138. <a href=\"https:\/\/doi.org\/10.1128\/CMR.00057-13\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/doi.org\/10.1128\/CMR.00057-13<\/a>&nbsp;<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Prepare for the USMLE Step 1 exam with this detailed question about a 28-year-old woman experiencing severe abdominal pain and jaundice after returning from a trip to Southeast Asia. What family of viruses causes patchy necrosis of the liver? Test your knowledge and deepen your understanding of viral infections. A 28-year-old Gravida 1 para 0 [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":4745,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[27,11,20,34,16,1366,1369,44],"tags":[],"class_list":["post-4743","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicine","category-comlex","category-exam-prep","category-omm","category-do","category-questions","category-step-1-questions","category-step-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>USMLE\u00ae Step 1 Question of the Day:\u00a0Viral hepatitis - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/usmle-step-1-question-of-the-day-viral-hepatitis\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"USMLE\u00ae Step 1 Question of the Day:\u00a0Viral hepatitis - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Prepare for the USMLE Step 1 exam with this detailed question about a 28-year-old woman experiencing severe abdominal pain and jaundice after returning from a trip to Southeast Asia. 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