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Case 9 answers

Results of Gina’s blood tests from Case 8
Rubella serology = negative
HBsAg, and anti-HBc= positive; anti-HBs= negative
VDRL= negative
HIV- reverse transcriptase PCR = negative
CMV serology = positive
Toxoplasma serology= negative
VZV serology= positive


After questioning her further you discover she had jaundice about 4 years ago. Her old chart reveals she was positive for HBsAg and anti-HBc and negative for anti-HBs.

Which stage of Hepatitis B infection is Gina currently experiencing?

  1. acute hepatitis; would have the same serological results however, you have an old chart that says 4 years ago she had the same results she has today. no symptoms
  2. the window period of hepatitis; positive for anti-HBc but negative for HBsAg and anti-HBs
  3. convalescense; positive for anti-HBc and anti-HBs but negative for HBsAg
  4. chronic hepatitis*; positive for HBsAg for more than 6 months. The definition for chronic HBV hepatitis.
  5. she never had hepatitis; would have been negative for all three tests or only positive for anti-HBs if she had been vaccinated.


After discussing Gina’s tests further she mentions being very concerning about giving her baby hepatitis. Which test, if positive, would indicate that she is more likely to give her child hepatitis?

  1. HBsAg
  2. anti-HBs
  3. anti-HBc
  4. HBeAg*
  5. anti-Hbe

You are also concerned about her negative Rubella titer and suggest she receive a vaccine to prevent problems in her future child. What vaccine would you suggest she receive?

  1. DTaP- diphtheria, tetanus, acellular pertussis
  2. Hib- Haemophilus influenzae type b
  3. Hep B- HBV vaccine
  4. MMR*- mumps, measles, rubella
  5. VZV vaccine- varicella zoster vaccine

About how long should she wait before getting pregnant after receiving this vaccine (from above) and why should she wait?

  1. no wait needed; it is not a live vaccine
  2. no wait needed; it is a live vaccine
  3. 2 weeks; it is not a live vaccine
  4. 2 weeks; it is a live vaccine
  5. 4 weeks; it is not a live vaccine
  6. 4 weeks; it is a live vaccine


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Neal Chamberlain, PhD. A. T. Still University of Health Sciences/Kirksville College of Osteopathic Medicine.

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