USMLE HBV Tx

[stankyle]

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Hi everyone, I have a question regarding Tx criteria of Hep B.

According to UW 2Ck, pt should meet at least 1 of the following 4 criteria to receive Tx.

1. Acute liver injury
2. Clinical complications of cirrhosis w/ Inc HBV DNA
3. Pt w/o cirrhosis BUT w/ +ve HBeAg, HBV DNA >20,000 and ALT > 2x normal
4. Immunosuppressed or pt receiving chemo. ( to prevent reactivation)

I took 2CK recently and have just started UW Step 3 which has contradictory guidelines- Question describes a scenario where pt is HBeAg +ve and has ALT >2 x normal, yet the right answer is "Supportive measures only" (and NO Tx)

@Phloston would like to have your thoughts on this as well.

Not sure if I should be posting this on CK forums but thought those preparing for it might also benefit.

Thanks!

 

[Phloston]

Not really sure quite honestly. I'd just check UpToDate, which surpasses UW anyway. I'd say the one good thing about being beyond 2CK is that borderline questions are irrelevant, especially since scores don't mean anything for Step 3.

 

[CaliAtenza]

Hi everyone, I have a question regarding Tx criteria of Hep B.

According to UW 2Ck, pt should meet at least 1 of the following 4 criteria to receive Tx.

1. Acute liver injury
2. Clinical complications of cirrhosis w/ Inc HBV DNA
3. Pt w/o cirrhosis BUT w/ +ve HBeAg, HBV DNA >20,000 and ALT > 2x normal
4. Immunosuppressed or pt receiving chemo. ( to prevent reactivation)

I took 2CK recently and have just started UW Step 3 which has contradictory guidelines- Question describes a scenario where pt is HBeAg +ve and has ALT >2 x normal, yet the right answer is "Supportive measures only" (and NO Tx)

@Phloston would like to have your thoughts on this as well.

Not sure if I should be posting this on CK forums but thought those preparing for it might also benefit.

Thanks!

Which question is that info covered in? I just went through Uworld searching for Hepatitis and I didn't see what you were talking about.

 

[stankyle]

Which question is that info covered in? I just went through Uworld searching for Hepatitis and I didn't see what you were talking about.

I'm sorry I don't have my CK subscription anymore, the question was about the treatment where lamvivudine or entacavir (don't exactly remember which) was the right answer, the Tx criteria was in the explanation.

 

[CaliAtenza]

I'm sorry I don't have my CK subscription anymore, the question was about the treatment where lamvivudine or entacavir (don't exactly remember which) was the right answer, the Tx criteria was in the explanation.

Ah okay. I'll check it out, thanks 🙂.