hep tx

Question 1

surface antigen for Hep ___ and antibody for Hep ___

Answer 1

B

C

Question 2

Risk factors of Hep C

Answer 2

Injection drug use*****

Baby boomer

multiple sexual partners

incarceration, occupational

long term hemodialysis

blood transfusion prior to 1992

clotting factor tx prior to 1987

Question 3

Hep B therapy patient requirements

Answer 3

positive HBsAG

HBeAG(+/- will change tx)

ALT

Question 4

FDA tx for Hep B

Answer 4

First line

• PEG-IFN
• Entecavir
• Tenofovir

Second Line tx

• IFN
• Lamivudine
• Adefovir
• Telbivudine

Question 5

Hep B, even in the absence of cirrhosis, can predispose to

Answer 5

HCC

Question 6

What is the first test that becomes positive for Hep B?

Answer 6

surface antigen

Question 7

window period is

Answer 7

loss of surface antigen before anti-HBs, some IgM-HBc (24-32 weeks)

Question 8

Which serological markers are present in chronic infection of Hep B?

Answer 8

HBsAg and total antiHBc

not necessarily IgM anti-HBc

Question 9

what is eAntigen?

Answer 9

mark of viral replication

Question 10

Which marker is in actively infected Hep B patient versus someone who could be immunized?

Answer 10

HBsAg is the main marker for infectivity

HBsAb in both immunized and exposed

Question 11

what is eAntigen?

Answer 11

mark of viral replication

assess treatment response

Question 12

Which marker is in actively infected Hep B patient versus someone who could be immunized?

Answer 12

HBsAg is the main marker for infectivity

HBsAb in both immunized and exposed

Question 13

Acute hep B marker and important for what other hepatitis?

Answer 13

Hep B Core Antibody IgM (HBc IgM) important for Hepatitis D infectiond

Question 14

Hepatits Core Ab IgM + IgG total

Answer 14

someone exposed

Question 15

Hep B surface Antibody no core Ab

Answer 15

immunized

Question 16

Quantitative assay reports

Answer 16

viral load to assess treatment response

Question 17

Inactive Chronic Hep B

Answer 17

HBsAg+> 6 months

no HBeAGg, HBeAb
HBV DNA <2,000

normal AST/ALT

liver biopsy without significant hepatitis

Question 18

Interferon

Answer 18

not well tolerated but great sAg loss

Question 19

Lamivudine

Answer 19

high risk of resistance, could be used for viral suppression during chemo

Question 20

Telbivudine

Answer 20

used in Asia

Question 21

Entecavir

Answer 21

common but low sAg loss.

Question 22

Sexual blood exposures should be avoided in

Answer 22

Hep B

Question 23

Check for HBsAg in all patients about to initiate

Answer 23

chemo

Question 24

Mother with Hep B pregnant, what should be done?

Answer 24

immunize the baby immediately and HBIg

Question 25

Tenofovir and Telbivudine can be used for

Answer 25

pregnant mothers in the 3rd trimester

Question 26

fulminant hep b serology

Answer 26

HBsAg+, HBc IgM+

Question 27

mot important screening for HCC for which hepatitis

Answer 27

Hepatitis B

Question 28

Hep C most prevalent

Answer 28

Egypt

Question 29

what percentage of Acute HCV turns to chronic infection and percentage to cirrhosis?

Answer 29

70-85% (Anti-HCV Ab+, HCV RNA +), 30% to cirrhosis

Question 30

HCV IgG Ab is not diagnostic, what is?

Answer 30

RNA by PCR

Question 31

common Hep genotypes in US

Answer 31

1a, 1b

Question 32

HCV IgG Ab is not diagnostic, what is used to confirm infected state?

Answer 32

RNA by PCR

Question 33

common Hep genotypes in US

Answer 33

1a, 1b

Question 34

What leads to a more rapid and progressive course of HCV

Answer 34

Alcohol

Question 35

what else should you test for in HCV infected person?

Answer 35

HIV (30% HIV+ concomitantly infected with HCV)

Question 36

extrahepatic Hep C manifestations?

Answer 36

Porphyria cutanea tarda Leukocytoclastic vasculitis Glomerulonephritis Non-Hodgkin's lymphoma AutoI thyroiditis DM Sjogren's

Question 37

Sustained Virological Response code word for

Answer 37

hep c is CURED

Question 38

PEG-IFN/RBV side affect

Answer 38

suicide

Question 39

What class of drugs are direct acting HCV therapies? *reference*

Answer 39

NS3/4A protease inhibitors NS5B Nucleotide Polymerase Inhibitor NS5B Non-nucleotide Polymerase Inhibitor NS5A Inhibitors

Question 40

Genotype 1 drug?

Answer 40

Harvoni (1) Viekira Pak (1ab) Zepatier

Question 41

Genotype 1-6 drug

Answer 41

Epclusa