Vesiculobullous disorders: hepatitis B screening before rituximab: practice question

A Dermatology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dermatology · Vesiculobullous disorders: hepatitis B screening before rituximab

Sample item

A 40-year-old with refractory pemphigus vulgaris is planned for rituximab. Which check is essential beforehand because of a risk of fulminant reactivation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. HBsAg and anti-HBc

Rituximab depletes B cells and can reactivate hepatitis B, even in people who are HBsAg negative but anti-HBc positive. Screening and prophylaxis or monitoring are needed before it is given.

Option by option

  • A. Anti-HCV only

    Anti-HCV alone does not detect the principal reactivation risk of this agent.

  • B. Serum amylase

    Serum amylase screens for pancreatitis and is unrelated.

  • C. HBsAg and anti-HBc (correct)

    Correct. HBsAg and anti-HBc identify the risk of hepatitis B reactivation.

  • D. HIV p24 antigen only

    HIV p24 antigen testing alone does not address this reactivation risk.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is C, HBsAg and anti-HBc. Rituximab depletes B cells and can reactivate hepatitis B, even in people who are HBsAg negative but anti-HBc positive.

Why is "Anti-HCV only" not the answer?

Anti-HCV alone does not detect the principal reactivation risk of this agent.

Why is "Serum amylase" not the answer?

Serum amylase screens for pancreatitis and is unrelated.

Why is "HIV p24 antigen only" not the answer?

HIV p24 antigen testing alone does not address this reactivation risk.

What concept does this question test?

It tests Vesiculobullous disorders: hepatitis B screening before rituximab in Dermatology. Screening and prophylaxis or monitoring are needed before it is given.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vesiculobullous disorders: hepatitis B screening before rituximab?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.