Hepatitis A is the only type that is transmitted by the fecal-oral route through contaminated food. Endemic rates are high in developing countries with low socioeconomic conditions and poor sanitation and hygiene practices. Exposure in these developing countries usually occurs in childhood. The incidence of HAV in a given population correlates with socioeconomic properties such as income, the density of housing, sanitation, and water quality.

Option A: Hepatitis B infection is a serious global healthcare problem. Often transmitted via body fluids like blood, semen, and vaginal secretions, the hepatitis B virus can cause liver injury. It involves the transmission of HBV through sexual contact or mucosal surface contact. Unprotected sex and injection drug use are major modes of transmission in low to intermediate prevalence areas.
Option C: The patients should be told not to donate blood or any organs as the risk of transmission is high. Hepatitis C is a serious infection that has high morbidity and mortality. The management of HCV is prohibitively expensive, and newer antivirals offer a potential cure for the disorder.
Option D: Hepatitis B, C, and D are transmitted through infected bodily fluids. Hepatitis D virus infection is an acute and chronic inflammatory process transmitted parenterally. Hepatitis D replicates independently within hepatocytes but requires hepatitis B surface antigen for propagation. Hepatic cell death occurs due to direct cytotoxic effects of hepatitis D virus or a host-mediated immune response. Risk factors include blood transfusions and intravenous drug use.

Hepatitis C is a viral infection transmitted through bodily fluids, such as blood, causing inflammation of the liver. Patients with hepatitis C may not donate blood for transfusion due to the high risk of infection in the recipient. Transmission can be parenteral, perinatal, and sexual, with the most common mode being the sharing of contaminated needles among IV drug users. Also, other high-risk groups include people who require frequent blood transfusions and organ transplantation of organs from infected donors.

Option B: Cholecystitis is inflammation of the gallbladder that occurs most commonly because of an obstruction of the cystic duct by gallstones arising from the gallbladder (cholelithiasis). Ninety percent of cases of cholecystitis involve stones in the gallbladder (ie, calculous cholecystitis), with the other 10% of cases representing acalculous cholecystitis.
Option C: Diverticular disease (diverticulosis, diverticulitis) is a general term that refers to the presence of diverticula, small pouches in the large intestinal (colonic) wall. The cause of diverticulosis is unclear, but it has been associated with increased pressure from constipation or increasing abdominal girth in obesity. The classic high-fat and low-fiber diet of the Western culture may be a major contributor to the development of diverticulosis.
Option D: Crohn’s disease is an idiopathic, chronic inflammatory process that can affect any part of the gastrointestinal tract from the mouth to the anus. Crohn’s disease is believed to be the result of an imbalance between proinflammatory and anti-inflammatory mediators. Although genetic susceptibility, luminal antigenic drive, and environmental triggers are also important factors, animal models demonstrate that no single factor is sufficient to induce intestinal inflammation.

Naproxen sodium is a nonsteroidal anti-inflammatory drug that can cause inflammation of the upper GI tract. For this reason, it is contraindicated in a patient with gastritis. COX-1 and COX-2 inhibition lead to decreased prostaglandin synthesis in the gastric mucosa. The prostaglandins maintain mucosal integrity, therefore decreased synthesis causes reduced protection to the tissue. However, studies indicate COX-1 has a more significant effect on the integrity of the mucosa; consequently, selective COX-2 inhibitors such as Celecoxib do not have as much of an effect on gastric tissue.

Option B: Calcium carbonate is used as an antacid for the relief of indigestion and is not contraindicated. Calcium carbonate is an inorganic salt primarily used in the management and treatment of low calcium conditions, GERD, CKD, and a variety of other indicated conditions. It is classified as a calcium supplement, antacid, and as a phosphate binder.
Option C: Clarithromycin is an antibacterial often used for the treatment of Helicobacter pylori in gastritis. Clarithromycin is in a class of medications called macrolide antibiotics. It works by stopping the growth of bacteria. Clarithromycin is used to treat certain bacterial infections, such as pneumonia (a lung infection), bronchitis (infection of the tubes leading to the lungs), and infections of the ears, sinuses, skin, and throat.
Option D: Furosemide is a loop diuretic and is contraindicated in a patient with gastritis. The Food and Drug Administration (FDA) has approved the use of furosemide in the treatment of conditions with volume overload and edema secondary to congestive heart failure exacerbation, liver failure, or renal failure including nephrotic syndrome.

Cholecystitis, inflammation of the gallbladder, is most commonly caused by the presence of gallstones, which may block bile (necessary for fat absorption) from entering the intestines. Patients should decrease dietary fat by limiting foods like fatty meats, fried foods, and creamy desserts to avoid irritation of the gallbladder.

Option A: People who go on an extremely low-calorie diet are more likely to develop gallstones than people on a moderately low-calorie diet. Eating a healthy, well-balanced diet full of fruits and vegetables is the best way to improve and protect the gallbladder’s health. Fruits and vegetables are full of nutrients and fiber, the latter of which is essential to a healthy gallbladder.
Option B: A low-fat diet with lean proteins is recommended for patients with cholecystitis. Foods with trans fats, like those in processed or commercially baked products, can also be harmful to gallbladder health.
Option C: Moderate consumption of sweet drinks can be allowed. Avoiding refined white foods, like white pasta, bread, and sugar, can protect the gallbladder. Eat whole-grain cereals, whole-grain bread, whole-grain crackers, brown rice, or whole-grain pasta. Avoid high-fat foods such as croissants, scones, biscuits, waffles, doughnuts, muffins, granola, and high-fat bread.

Patients with pulmonary edema experience air hunger, anxiety, and agitation. Patients usually present with shortness of breath, which may be acute in onset (from minutes to hours) or gradual in onset occurring over hours to days, depending upon the etiology of pulmonary edema.

Option A: Tachypnea is usually present, with the patient gasping for breath. Dyspnea and tachypnea are usually present, and may be associated with the use of accessory muscles of respiration. After initial airway clearance, oxygenation assessment, and maintenance, management mainly depends upon presentation and should be tailored from patient to patient. Supplemental oxygen is a requirement if the patient is at risk of hypoxemia (SPO2 less than 90% ).
Option C: Respiration is fast and shallow and heart rate increases. Tachycardia and hypotension may be present along with jugular venous distention. Auscultation of the heart helps to differentiate between the various causes of valvular lesions causing pulmonary edema.
Option B: Stridor is noisy breathing caused by laryngeal swelling or spasm and is not associated with pulmonary edema. Fine crackles are usually heard at the bases of lungs bilaterally, and progress apically as the edema worsens. Ronchi and wheeze may also be presenting signs.