hepatitis questions from fitzgerald book

Question 1

A 36 year old man c/o nausea, fever, malaise and abdominal pain.  He shows signs of jaundice and reports darkly-colored urine  Diagnostic results show elevated serum aminotransferase less than 10x upper limits of normal (ULN). His most likely diagnosis is:
A. GERD
B. viral hepatitis
C. crohn's disease
D. barrett esophagus

Answer 1

B viral hepatitis

Question 2

a serological marker for acute hepatitis A virus (HAV) infection is:
A. HAV IgM
B. HAV viral RNA
C. TNF-alpha
D. IL-10

Answer 2

A. HAV IgM

Question 3

You are caring for a 45 year old woman from a developing country. She reports that she had “yellow jaundice” as a child. Her PE is unremarkable. Her lab studies are as follows: AST 22 U/L (normal 0-31), alanine aminotransferase ALT 25 U/L, (normal 0-40), hepatitis A virus immunoglobulin G (HAV IgG) positive: Laboratory testing reveals
A. chronic hepatitis A
B. no evidence of prior or current hepatitis A infection
C. resolved hepatitis A infection
D. prodromal hepatitis A

Answer 3

C. resolved hepatitis A infection

Question 4

The most common source of hepatitis A infection is:
A. sharing IV drug equipment
B. cooked seafood
C. contaminated water supplies
D. sexual contact

Answer 4

C. contaminated water supplies

Question 5

In addition to the lab work described, results reveal the following for the above mentioned patient: hepatitis B surface antigen (HBsAG) positive. These findings are most consistent with:
A. no evidence of hepatitis B infection
B. resolved hepatitis B infection
C. chronic hepatitis B
D. evidence of effective hepatitis B immunization

Answer 5

C. chronic hepatitis B

Question 6

The average incubation time for HAV is:
A. 10 days
B. 28 days
C. 60 days
D. 6 months

Answer 6

B. 28 days

Question 7

Current vaccine guidelines recommend administering the immunization against HAV to:
A. those living or traveling to areas endemic for the disease
B. food handlers and day care providers
C. military personnel
D. any person who wishes to receive the vaccine

Answer 7

D. any person who wishes to receive the vaccine

Question 8

You see a 27 year old man who says he ate at a restaurant last week that was later reported to have a worker identified with hepatitis A. He is healthy and shows no signs of infection but is concerned about contracting HAV infection. You recommend:
A. HAV vaccine
B. HAV immune globulin
C. HAV vaccine plus immune globulin
D. no intervention at this time and wait until symptoms manifest

Answer 8

A. HAV vaccine

Question 9

A 38 year old man with a recent history of IV drug use presents with malaise, nausea, fatigue and “yellow eyes” for the past week. After ordering diagnostic tests, you confirm the diagnosis of hepatitis B. Anticipated laboratory results include:
A. the presence of hepatitis B surface antibody (HBsAb)
B. neutrophilia
C. thrombocytosis
D. the presence of HBsAg

Answer 9

D. the presence of HBsAg

Question 10

Clinical findings in patients with acute hepatitis B likely include all of the following except:
A. abdominal rebound tenderness
B. scleral icterus
C. a smooth, tender, palpable hepatic border
D. report of myalgia

Answer 10

A. abdominal rebound tenderness

Question 11

Risk factors for hepatitis B infection include all of the following except
A. having multiple sexual partners
B. having an occupation that exposes you to human blood
C. injection drug user
D. eating food prepare by a person with an HBV infection

Answer 11

D. eating food prepare by a person with an HBV infection

Question 12

You see a woman who has been sexually active without condom use with a man newly diagnosed with acute hepatitis B. She has not received hepatitis B immunization. You advise her to:
A. start hepatitis B immunization series.
B. limit the number of sexual partners
C. be tested for HBsAb
D. receive hepatitis B immune globulin and hepatitis B immunization series.

Answer 12

D. receive hepatitis B immune globulin and hepatitis B immunization series.

Question 13

Routine testing for the presence of HBsAb after immunization with the HBV vaccine is recommended for all the following except:
A. healthcare providers
B. immunocompromised patients.
C. restaurant workers
D. dialysis patients

Answer 13

C. restaurant workers

Question 14

Which of the following statements is true regarding hepatitis C infection:
A. it usually manifests with jaundice, fever and significant hepatomegaly
B. among healthcare workers, it is most commonly found in nurses
C. at least 50% of persons with acute hepatitis C go on to develop chronic infection
D. interferon therapy is consistently curative

Answer 14

C. at least 50% of persons with acute hepatitis C go on to develop chronic infection

Question 15

To prevent an outbreak of hepatitis D infection, a NP plans to:
A. promote a campaign for clean food supplies
B. immunize the population against hepatitis B
C. offer antiviral prophylaxis against the agent
D. encourage frequent hand washing.

Answer 15

B. immunize the population against hepatitis B

Question 16

Monitoring for hepatoma in a patient with chronic hepatitis B or C often includes periodic evaluation of:
A. ESR
B. HBsAb
C. alpha-fetoprotein
D. bilirubin

Answer 16

C. alpha-fetoprotein

Question 17

You see a 48 year old woman with non alcoholic fatty liver disease. Evaluation of infectious hepatitis includes the following
Anti-HAV IgG negative
Anti-HBs negative
Anti HCV negative
When considering the overall health status, you advise receiving which of the following vaccines?
A. immunization against hepatitis A and B as based on her lifestyle risk factors
B. Immunization against hepatitis B and C
C. immunization against hepatitis A and B
D. immunization against hepatitis A, B and C

Answer 17

C. immunization against hepatitis A and B

Question 18

Which of the following hepatitis forms is most effectively transmitted from the man to the woman via heterosexual vaginal intercourse:
A. hepatitis A
B. hepatitis B
C. hepatitis C
D. hepatitis D

Answer 18

B. hepatitis B