Trial

1 / 4

A 30-year-old primip attends her booking visit at 8 weeks. Her Hepatitis B serology shows:

HBsAg: Negative

Anti-HBs (HBsAb): Positive

Anti-HBc (total): Negative

Anti-HBc (IgM): Negative

What is the most likely interpretation of her serology?

Susceptible to Hepatitis B

Acute Hepatitis B infection

Immune due to vaccination

Chronic Hepatitis B infection

Immune due to natural infection

Hepatitis B serology

HBs Ag	HBs Ab (anti-HBs)	Total HBc Ab (anti-HBc)
–	–	–	Susceptible
–	+	–	Immune (vaccine)
–	+	+	Immune (natural)
+	–	+ (IgM HBc positive)	Acute infection
+	–	+ (IgM HBc negative)	Chronic infection
–	–	+	Resolved infection OR false positive / resolving acute / low level chronic

HBs Ag – Hepatitis B surface antigen

HBc Ag – Hepatitis B core antigen

HBe Ag – Hepatitis B ‘E’ antigen = correlates with virus replication and infectivity. Anti-HBe = correlates with lower virus replication and remission.

Hepatitis B serology

HBs Ag	HBs Ab (anti-HBs)	Total HBc Ab (anti-HBc)
–	–	–	Susceptible
–	+	–	Immune (vaccine)
–	+	+	Immune (natural)
+	–	+ (IgM HBc positive)	Acute infection
+	–	+ (IgM HBc negative)	Chronic infection
–	–	+	Resolved infection OR false positive / resolving acute / low level chronic

HBs Ag – Hepatitis B surface antigen

HBc Ag – Hepatitis B core antigen

HBe Ag – Hepatitis B ‘E’ antigen = correlates with virus replication and infectivity. Anti-HBe = correlates with lower virus replication and remission.

2 / 4

What is the maternal mortality rate in the UK? (latest MBRRACE-UK data)

5.60 per 100,000

6.80 per 100,000

9.3 per 100,000

12.80 per 100,000

14.10 per 100,000

Latest MBRRACE-UK data (2022-24) top stats to memorise are:

Maternal mortality rate:

12.80 per 100 000 maternities (leading cause thrombosis and thromboembolism)
Black community – 32.4 per 100 000 maternities, Chinese – 5.3 per 100 000 maternities, White – 11.93 per 100 000 maternities. Black women have 3x higher maternity rate.
Women living in the next most deprived areas (IMD IV) had maternal mortality rates that were also nearly twice that of women living in the least deprived areas.
Leading cause = thromboembolism

Indirect deaths rate = 7.06 per 100 000 maternities

Direct deaths rate = 5.74 per 100 000 maternities

Late deaths (between six weeks and one year after the end of pregnancy) rate = 16.32 per 100 000 maternities. Leading cause = maternal suicide.

Latest MBRRACE-UK data (2022-24) top stats to memorise are:

Maternal mortality rate:

12.80 per 100 000 maternities (leading cause thrombosis and thromboembolism)
Black community – 32.4 per 100 000 maternities, Chinese – 5.3 per 100 000 maternities, White – 11.93 per 100 000 maternities. Black women have 3x higher maternity rate.
Women living in the next most deprived areas (IMD IV) had maternal mortality rates that were also nearly twice that of women living in the least deprived areas.
Leading cause = thromboembolism

Indirect deaths rate = 7.06 per 100 000 maternities

Direct deaths rate = 5.74 per 100 000 maternities

Late deaths (between six weeks and one year after the end of pregnancy) rate = 16.32 per 100 000 maternities. Leading cause = maternal suicide.

3 / 4

The standard CXR (0.02 mSv) is equivalent to how many days of natural background radiation?

1 day

3 days

10 days

14 days

21 days

CXR = 0.02 mSv to 0.1 mSv, this gives a range of background radiation of a CXR of 3 – 10 days.

NB – the question should specify the effective dose :

CXR 0.02 mSv = 3 days background radiation
CXR 0.1 mSv = 10 days background radiation

CXR = 0.02 mSv to 0.1 mSv, this gives a range of background radiation of a CXR of 3 – 10 days.

NB – the question should specify the effective dose :

CXR 0.02 mSv = 3 days background radiation
CXR 0.1 mSv = 10 days background radiation

4 / 4

Cowdry bodies are intranuclear inclusion bodies seen in cells infected with which virus?

Varicella zoster virus

Hepatitis B

Treponema pallidum

HPV 16

HPV 6

There are 2 types:

Type A Cowdry bodies = seen in herpes simplex and VZV
Type B Cowdry bodies = seen in poliovirus and CMV

There are 2 types:

Type A Cowdry bodies = seen in herpes simplex and VZV
Type B Cowdry bodies = seen in poliovirus and CMV

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