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A 32-year-old G2P1 at 32 weeks gestation presents to the emergency department with complaints of severe abdominal pain, fatigue, and nausea. Physical examination is significant for profound jaundice and tenderness to palpation of the right upper quadrant of the abdomen. The patient returned 2 weeks ago from a 1 month-long trip to India. She received sporadic pre-natal care while traveling and reports no known complications in her current pregnancy to date. She denies any past medical problems and states that her prior pregnancy proceeded as a normal vaginal birth without any complications. Infection with which of the following organisms would portend the worst prognosis with the highest mortality rate for this patient?
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A 44-year-old woman presents to the emergency department with jaundice and diffuse abdominal pain. She denies any previous medical problems and says she does not take any medications, drugs, or supplements. Her temperature is 97.6°F (36.4°C), blood pressure is 133/87 mmHg, pulse is 86/min, respirations are 22/min, and oxygen saturation is 100% on room air. Physical exam is notable for sclera which are icteric and there is tenderness to palpation over the right upper quadrant. Laboratory studies are ordered as seen below.Hepatitis B surface antigen: PositiveHepatitis B surface IgG: NegativeHepatitis B core antigen: PositiveHepatitis B core IgG: PositiveHepatitis B E antigen: PositiveHepatitis B E IgG: PositiveWhich of the following is the most likely diagnosis?
Acute hepatitis B infection
Chronic hepatitis B infection
Hepatitis B vaccination
No hepatitis B vaccination or infection
Resolved hepatitis B infection