HIV PH 613 Day 5 AM DELLAROLE

Question 1

Hepatitis B = DNA virus

Accepted Answer

Protect babies (neonatal) about 90% will become chronic, transmission via blood and body fluids (saliva, semen, vaginal), Can survive outside the body for at least 7 days, Infected mother to newborn; delivering baby. Children are asymptomatic.

Question 2

First lines for HBV

Accepted Answer

ENTECAVIR = BARAC, PEG, VIREAD = TEN DIS

Question 3

Viral Hepatitis in general

Accepted Answer

Antibodies = Presence of infection. IgM and IgG, Current infection when you have Antigens., Antigen (AG) = Infection if it is viral DNA/RNA

Question 4

Recommended regimens for treatment-naive patients without cirrhosis:

Accepted Answer

Mayret and Epclusa are approved for all 6 HCV genotypes (pan-genotypic), Glecaprevir/pibrentasvir (Mayret), Sofosbuvir/velpatasvir (Epclusa)

Question 5

HBsAg + IgM what type of infection?

Accepted Answer

Acute, Later phase of Acute infection, If infection resolves = you'll see Antibodies not Antigen

Question 6

Infection from acute can become chronic

Accepted Answer

Symptoms and treatment depend on the type of virus & extent of liver damage, Many patients don't know that they are asymptomatic, Can become liver cancer, Can become cirrhosis

Question 7

Ribavirin

Accepted Answer

2 contraception methods and for 6 months after completion of treatment, Not first line, Never used in monotherapy, Teratogenic, hemolytic anemia, monitor for pregnancy test, CBC differential

Question 8

IgM: A current or recent acute infection while IgG indicates a current or past infection, and immunity.

Accepted Answer

IgM: Fast and Peak, IgG: produces later.

Question 9

Antigens are foreign substances that get into the body and cause an immune system response; that cause antibodies.

Accepted Answer

True

Question 10

Adamantane /Rimantadine (Flumadine)

Accepted Answer

Not really used, Seizures use with caution, Avoid use if psychosis

Question 11

Cirrhosis

Accepted Answer

Diagnose via liver biopsy; looking at the tissue, LFT, AST,ALT,ALP,Tbili, alkaline phosphatase, PT/INR ↑ Albumin ↓, Healthy cells replaced with fibrotic tissue; impaired blodd flow, Usually irreversible. Due by HCV and alcoholism.

Question 12

Ritonavir

Accepted Answer

Not recommend Interferon. Only if contraindicated or if drug too expensive, Only used as Booster

Question 13

Side effects for NRTI

Accepted Answer

Monitor: Exacerbation of HBV upon discontinuation, Can cause HIV resistance in HBV patients, Lactic Acidosis, Hepatomegaly with steatosis

Question 14

In early acute infection HBsAg is the only + marker, Abs are all negative and HBeAg is also +

Accepted Answer

True

Question 15

HBsAg what type of infection?

Accepted Answer

Acute, Current, Early

Question 16

HAV VIRUS Serology

Accepted Answer

IgG anti-HAV = immunity: we had infection in the past. Host immunity, IgM anti-HAV: Antibody testing = Acute /Early/recent infection

Question 17

Influenza

Accepted Answer

Neuraminidase inhibitors, endonuclease inhibitors, adamantanes, Seasonal Influenza Vaccine 6 months and +

Question 18

Entecavir (Baraclude)

Accepted Answer

Absorption of the drug decreases with food. Drug will be ineffective, Take on an empty stomach.

Question 19

In the treatment of influenza when is the appropriate time to start Tamiflu

Accepted Answer

Within 48 hours of symptom onset

Question 20

HBsAg and HBeAg both +

Accepted Answer

Acute hepatitis B, Early infection and high infectivity

Question 21

Acute Infection of HBV treatment: Treat ONLY when Severe: INR > 1.5, Billirubin > 3, hepatic encelopathy, or acistes

Accepted Answer

INF/peg-INF preferred (increases half life once a week), Chronic surface antigen > 6 months + active viral replication (HBeAg+), Interferons have toxicities and lab abnormalities that limit their use, NRTIs: Entecavir or Tenofovir

Question 22

Anti-HBs

Accepted Answer

Produced in response to vaccination, Failure to develop anti-HBs = chronic infection, Appear later; persists for years and provides protective immunity

Question 23

Immunoglobuling: Prevent disease and provide immediate protection

Accepted Answer

Travelers to countries with high or intermediate risk of infection, Short-term, Recommend in preexposure prophylaxis. Immunocompromised.

Question 24

HCV Treatment Option

Accepted Answer

SVRresponse: Abscence of detectable virus 12 weeks after completion: Cured, All with acute/chronic

Question 25

HBsAg (surface antigen) is + during any type of acute infection (early and not)

Accepted Answer

True

Question 26

Hepatitis

Accepted Answer

Viruses are most common. Other: Alcohol, Drugs, Autoimmune diseases, Many are asymptomatic

Question 27

Vaccines for HAV: Havrix and VAQTA: for Hepatitis A

Accepted Answer

recommend for pre-exposure prophylaxis, Two doses for all children

Question 28

Influenza general

Accepted Answer

respiratory virus, inluenza A and B november and march, respiratory droplets from coughing and sneezing, 5-7 days after becomig ill can be contagious, A person can be contagious one day prior to having symptoms.

Question 29

Pan-genotypic covers all.

Accepted Answer

True

Question 30

Viral Hepatitis A: HAV: RNA virus

Accepted Answer

Rarely it can be fulminant. Generally does not become chronic., Acute, self-limiting (pts don't know they have it & it resolves by itself), Disease is ONLY Acute, Transmitted by fecal-oral route. Wash hands as prevention.

Question 31

Diagnose with Serology

Accepted Answer

Not easily cultured, Detects antigen, antibodies, and viral load, Use Serological panels

Question 32

In the treatment of influenza which medication has the advantage of being dosed once?

Accepted Answer

Baloxavir (Xofluza)

Question 33

HCV - RNA

Accepted Answer

anti-hcv antibody, can give false positive, Blood / bodily fluid, can survive up to 30 wks outside; high mutation rate

Question 34

HBV Management

Accepted Answer

Prophylaxis: HBIg immunoglobulin give 14 days of exposure, Pharmacotherapeutic Interferon (INF-alpha), Prophylaxis Vaccine for Pre-exposure, Pharmacotherapeutic: NRTIs

Question 35

Current, acute infections (not early, later phase of acute infection)

Accepted Answer

HBsAg +, HBc Abs (total and IgM) +, HBs Abs -

Question 36

RNA assay (PCR) for HCV

Accepted Answer

Quantitative: How much virus you have. Viral load, Qualitative Assay: If you have the virus

Question 37

viral load: The amount of virus we have in the body

Accepted Answer

True

Question 38

In the treatment of influenza which medication has the highest risk for neuropsychiatric events?

Accepted Answer

Oseltamivir, Tamiflu

Question 39

Adults at increased risk of infection or severe outcomes

Accepted Answer

Occupational exposures, traveling to countries with high risk of infection, IV drug users, Chronic liver disease, Clotting factor disorders (hemophilia), Men who have sexx with men

Question 40

Past/resolved, not-recent infection:

Accepted Answer

Total HBc Abs +, HBs Abs +

Question 41

In later phases of acute infections, both HBsAg and HBc Abs are +

Accepted Answer

True

Question 42

HBV serology: Antigens

Accepted Answer

HBcAg: core Antigen, HBeAg: E antigen, HBsAg: Surface Antigen

Question 43

HCV treatment

Accepted Answer

Sofosbuvir contraindicated with Amiodarone, Test for HBV before starting HCV treatment, Do not use with Inducers (decrease the level of the drugs), Hypoglycemia with insulin and other hypoglycemic drugs. Monitor BG

Question 44

Child-Tucotte-Pugh Classification on package inserts and used to assess chronic liver disease and cirrhosis

Accepted Answer

True

Question 45

Hepatitis A vaccine can be given with Hepatitis B: combination is called TWINRIX

Accepted Answer

True

Question 46

Prophylaxis Vaccine: Engerix B, Recombivax HB, Heplisav B

Accepted Answer

3 doses to get complete protection, Adults: Helathcare workers and prison workers, All children vaccinate: Given immediately after birth, Not approved in newborns (TwinRx)

Question 47

Hepatitis Virus Defintion & Etiology

Accepted Answer

Most common Malaise, fatigue, fever, GI upset, muscle pain, Can be with or without jaundice, Transmitted by fecal route, Transmission by oral route

Question 48

Current, early, acute infection:

Accepted Answer

HBsAg +, HBcAbs –

Question 49

Prevention/Prophylaxis:HAV: Active imunity with Vaccines & Passive Immunity with Immunoglobulins for pre & post exposure

Accepted Answer

True

Question 50

Severity of Liver disease

Accepted Answer

Predicts 3 month survival in patients ≥ 12 yr with liver cirrhosis, Liver Transplant, MELD

Question 51

In the treatment of influenza when is the requiremtn time to start Xofluza

Accepted Answer

Within 48 hours of symptom onset

Question 52

Hepatitis B genotypes

Accepted Answer

B and C most common in Asia, We don't do genotyping in Hepatitis B, "A" responsive to interferon, A/B/C most common

Question 53

HBsAg

Accepted Answer

Acute infection: Protein of virus in the blood, The first one that appears in the serum, Will decline when disease is resolved, If the antigen is there past > 6 months = Infection became chronic

Question 54

Which one is false about HBIg post-exposure prophylaxis?

Accepted Answer

Contains large amounts of hepatitis B antibodies taken from animal blood

Question 55

NRTIs for treatment for HBV

Accepted Answer

Approved as monotherapy for HBV (Entacavir or Tenofovir), All other are non-preferred, Test all patients for HIV before starting therapy

Question 56

Serologic Intepretation: HBsAg +, HBsAb -, Anti-HBc IgM+, total anti-HBc+

Accepted Answer

Acute current infection, Active infection, See antibody so IgM and total + Active

Question 57

Neuroaminidase Inhibitor: Oseltamivir (Tamiflu)

Accepted Answer

Treat: Age > 12. TAKE 75 MG BID FOR 5 DAYS. DOC for children and pregnant, (SJS/ TEN), anaphylaxis, Prophylaxis: Age > 12: TAKE 75 MG QD FOR 10 DAYS, Neuropsychiatric (sudden confusion, delirium, hallucinations, behavior)

Question 58

Inteferon Alfa

Accepted Answer

Used when other treatments are expensive., Can use alone or on combination INF + Rivavirin or INF + RBV + DAAs

Question 59

Management for HAV

Accepted Answer

Symptomatic treatment and supportive care: Diarrhea or Nausea/Vomiting, Most important: Prevention: Vaccine and Immunoglobulin Injections, Immunoglobulin Injection = Passive Immunity, Vaccine = Active immunity

Question 60

Endonuclease Inhibitor

Accepted Answer

Advantage single dose regime, Start within 48 hours of symptom onset, Block mRNA transcription by inhibiting viral endonuclease activity, Active against both influenza A and B

Question 61

Neuroaminidase inhibitors

Accepted Answer

Start 48 h of symptom onset for max benefit but if the earlier taken better, reduce complications, Active against both influenza A and B, Inhibit enzyme for the release of new viral particles from infected cells

Question 62

Signs and Symptoms of HAV

Accepted Answer

Can be asymptomatic and generally occur in children., Most infected adults are symptomatic, jaundice, malaise, fever, elevated serum aminotransferase levels

Question 63

Zanamivir (Relenza Diskhaler)

Accepted Answer

do not use in asthma/COPD or with any breathing problems, Neuropsychiatric events, bronchospasm, doesn't have doese adjustment in kidney impairment

Question 64

Anti-HBc (Antibodies)

Accepted Answer

Anti-HBc ARE the FIRST antibodies to be produced, IgM APPEARS first: current or recent infection / IgG persists for life

HIV PH 613 Day 5 AM DELLAROLE

Questions 83

HIV PH 613 Day 5 AM DELLAROLE

Questions 83