1. Hepatitis Tutoring
By Alaina Darby

2. FK is a 65 yo nurse who just completed a mission trip to the Middle East. It is thought that she may have ingested contaminated water during her trip. What form of viral hepatitis should she be most concerned about acquiring?
HIV
HAV
HBV
HCV b

3. Immunoglobulin administration Increased hand washing
FK is a 65 yo nurse who just completed a mission trip to the Middle East. It is thought that she may have ingested contaminated water during her trip. What should she do as prophylaxis against hepatitis after returning from her trip?
Immunoglobulin administration
Increased hand washing
Antiviral administration
Nothing a

4. FK is a 65 yo nurse who just completed a mission trip to the Middle East. It is thought that she may have ingested contaminated water during her trip. When would you expect to see symptoms should she develop hepatitis?
Within 2 weeks
Within 2 months
Within 6 months
Within 1 year b

5. Subsequent immunoglobulin administration Antiviral administration
FK is a 65 yo nurse who just completed a mission trip to the Middle East. It is thought that she may have ingested contaminated water during her trip. Regardless of immunoglobulin prophylaxis, she develops a fever, dark urine, and itching along with RUQ pain. What should be done?
Subsequent immunoglobulin administration
Antiviral administration
HAV vaccination
Nothing d

6. FK is a 65 yo nurse who just completed a mission trip to the Middle East. It is thought that she may have ingested contaminated water during her trip. You prophylaxed with immunoglobulin and gave supportive care for viral hepatitis. It is now 4 months later, what vaccinations should you not give her at this time (assuming all are indicated)?
MMR
Shingles
Pneumococcal
Flu b

7. JS is a 25 yo nurse who was accidentally stuck by a needle
JS is a 25 yo nurse who was accidentally stuck by a needle. Which of the following should she be most concerned about acquiring?
HIV
HAV
HBV
HCV c

8. JS is a 25 yo nurse who was accidentally stuck by a needle
JS is a 25 yo nurse who was accidentally stuck by a needle. She is to receive prophylaxis for HBV. How long should she receive HBIG?
1 week
2 weeks
3 weeks
4 weeks a

9. JS is a 25 yo nurse who was accidentally stuck by a needle 6 weeks ago
JS is a 25 yo nurse who was accidentally stuck by a needle 6 weeks ago. She has developed N/V, fever, and scleral icterus. Which of the following would be diagnostic of current HBV infection?
HBV surface antigen
Anti-HBs
Anti-HBc
HBV DNA 15,000 c

10. HBV…
Blood
Bodily fluids
Baby (at birth) b

11. HBsAg(+), anti-HBc(+), IgM anti-HBc(+), anti-HBs(-)
JS is a 25 yo nurse who was accidentally stuck by a needle 6 weeks ago. She has developed N/V, fever, and scleral icterus. Which of the following would you expect on serology?
HBsAg(+), anti-HBc(+), IgM anti-HBc(+), anti-HBs(-)
HBsAg(+), anti-HBc(+), IgM anti-HBc(+), anti-HBs(+)
HBsAg(-), anti-HBc(+), IgM anti-HBc(+), anti-HBs(-)
HBsAg(-), anti-HBc(+), IgM anti-HBc(+), anti-HBs(+) a

12. Serology… HBsAg… current infection Anti-HBc… is/was actually infected
IgM ant-HBc… acute illness
Anti-HBs… immune

13. JS is a 25 yo nurse who was accidentally stuck by a needle 6 weeks ago
JS is a 25 yo nurse who was accidentally stuck by a needle 6 weeks ago. Which of the following would be indicative of liver inflammation but not necessarily liver function in this patient?
INR
AST/ALT
Albumin
Platelets b

14. JS is a 25 yo nurse who was accidentally stuck by a needle 6 weeks ago
JS is a 25 yo nurse who was accidentally stuck by a needle 6 weeks ago. When should you start treating this patient for HBV hepatitis?
HBV DNA 12,000, AST 90, ALT 140
HBV DNA 12,000, AST 160, ALT 90
HBV DNA 18,000, AST 90, ALT 100
HBV DNA 18,000, AST 160, ALT 100 a

15. Treat when…
HBV DNA >20,000 Or
ALT >2x ULN (>100)

16. Labs: HBV DNA 12,000, AST 90, ALT 140, SCr 1.6, K+ 4.9
JS is a 25 yo nurse who was accidentally stuck by a needle 6 weeks ago.
Labs: HBV DNA 12,000, AST 90, ALT 140, SCr 1.6, K+ 4.9
Which of the following should be initiated?
Adefovir
Tenefovir
Lamivudine
Entecavir d

17. Labs: HBV DNA 12,000, AST 90, ALT 140, SCr 1.6, K+ 4.9
JS is a 25 yo nurse who was accidentally stuck by a needle 6 weeks ago.
Labs: HBV DNA 12,000, AST 90, ALT 140, SCr 1.6, K+ 4.9
Which of the following might be preferred in this patient if she already had been diagnosed with HIV?
Adefovir
Tenefovir
Lamivudine
Entecavir c

18. Healthcare worker born in 1987 Dialysis patient born in 1963
Which of the following patients would not be indicated for the HBV vaccine?
Healthcare worker born in 1987
Dialysis patient born in 1963
Person traveling to Australia born in 1950
Infant born 2 days ago (mother is negative) c

19. BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. Which of the following tests may not be helpful at this time?
ALT
HAV/HBV testing
Anti-HCV antibodies
HCV RNA c

20. BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. His testing comes back positive for HCV RNA and negative for Anti-HCV antibodies. What is your assessment?
Chronic HCV
HCV resolution
Acute HCV
No infection c

21. HCV RNA negative, Anti-HCV negative
BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. If he had previously been diagnosed with chronic HCV, what would you expect to see if this is an acute episode?
HCV RNA negative, Anti-HCV negative
HCV RNA negative, Anti-HCV positive
HCV RNA positive, Anti-HCV negative
HCV RNA positive, Anti-HCV positive d

22. HCV RNA negative, Anti-HCV negative
BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. What would you expect to see if treatment is successful and HCV resolves?
HCV RNA negative, Anti-HCV negative
HCV RNA negative, Anti-HCV positive
HCV RNA positive, Anti-HCV negative
HCV RNA positive, Anti-HCV positive b

23. HCV RNA negative x 4 weeks Anti-HCV negative x 4 weeks
BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. How would you determine if treatment is successful and HCV resolves?
HCV RNA negative x 4 weeks
Anti-HCV negative x 4 weeks
HCV RNA negative x 12 weeks
Anti-HCV negative x 12 weeks c

24. BK is a 62 yo WM who presents to you complaining of abdominal pain and dark urine. After treatment, HCV RNA is negative x 16 weeks. What is this considered?
SVR
RVR
EVR
ETR a