حضرات الزملاء والزميلات الافاضل
فيما يلي الامتحان الاول على ورقة التهاب الكبد الفيروسي سي
Cover story learning objectives were prepared by and the CE questions edited by Jeanne M. Isabel, CLSpH(NCA), MT(ASCP), Program Director and Associate Professor, School of Allied Health and Communicative Disorders, Northern Illinois University in DeKalb, IL.
1. The following facts about HCV infection are true except
a. most common chronic blood-borne infection in the United States.
b. leading cause of death in the United States.
c. long-term prognosis for chronic hepatitis C in majority of patients is relatively benign.
d. associated with an increased risk of liver cancer.
e. most common reason for liver transplant in the United States.
2. Which of the following factors is most important in preventing loss of HCV RNA from a sample after collection?
a. collection of samples in EDTA plasma
b. collection of samples with high-efficiency serum-separator tubes
c. rapid separation (within one hour) of serum and cells
d. storage of serum or plasma at 4°C within four hours of collection
e. storage of serum or plasma at –70°C within 24 hours of collection
3. Which of the following is associated with decreased rate of response to treatment in acute hepatitis C?
a. Age <40
b. Female gender
c. Genotype 1
d. Viral load <800,000 IU/mL
e. White ethnicity
4. The major criterion used to decide to continue treatment in a patient with hepatitis C is
a. ALT normalization at 12 weeks of treatment.
b. ALT normalization at 24 weeks of treatment.
c. viral load decreased by at least two logs at 12 weeks of treatment.
d. viral load decreased by at least two logs at 24 weeks of treatment.
e. viral load undetectable at 12 weeks of treatment.
5. A patient has been exposed to HCV. The most important test in determining infection with HCV is
a. ALT measurement at four, eight, and 12 weeks.
b. anti-HCV at four, eight, and 12 weeks.
c. HCV genotype in the donor.
d. HCV RNA viral load in the donor >1,000,000 IU/mL.
e. HCV RNA viral load in the recipient at four, eight, and 12 weeks.
6. Recombinant immunoblot assays (RIBA) are best used
a. in all patients with low positive anti-HCV.
b. in all patients with positive anti-HCV.
c. in all patients with positive anti-HCV and negative HCV RNA.
d. to confirm that patients with positive anti-HCV are currently infected.
e. to detect viral clearance in acute hepatitis C.
7. HCV genotype should be routinely done
a. after start of therapy to detect mutation.
b. before start of therapy to determine treatment duration.
c. in all patients with positive anti-HCV.
d. in all patients with positive anti-HCV and negative HCV RNA because of higher sensitivity of the assay.
e. only in persons who have failed treatment to detect resistance to antiviral agents.
8. A patient is found to be HCV RNA positive but anti-HCV negative. All of the following are reasonable explanations for this finding except
a. acute hepatitis-C infection.
b. dialysis patient infected with hepatitis C.
c. HIV-infected patient infected with hepatitis C.
d. recurrence of hepatitis C after liver transplantation.
e. infected patient with hepatitis C treated with immunosuppressants.
9. Infants born to HCV-infected mothers
a. should not be screened.
b. should be tested after 18 months of age.
c. will have a positive screening test.
d. will have a negative screening test.
10. A disadvantage of the HCV antibody-screening test by EIA is
a. failure to detect acute HCV infection.
b. false-positive in immunodeficient patients.
c. low specificity.
d. low sensitivity.
11. A positive HCV antibody confirmation test by RIBA can distinguish between a current or past infection.
12. All of the following statements related to advantages of the HCV RNA quantitative PCR are true except
a. The lower limit of detection is 200 IU/mL (500 RNA copies/mL).
b. It can be used as supplemental test in a patient suspected of having chronic disease with a positive antibody-screening test.
c. It can be used for diagnosis of acute infection and in immunodeficient patients suspected of having disease with a negative antibody-screen test.
d. It can be used to monitor therapy in patients with chronic disease.
e. HCV RNA can be transiently negative in persons with acute infection, and they will never go on to develop chronic infection.
13. A positive HCV NAT test indicates active HCV infection.
14. The HCV genotype(s) that have a better response to treatment is
a. genotype 1.
b. genotypes 2 and 3.
c. genotype 6.
d. None of the above.
15. Qualitative HCV RNA assays have a lower limit of detection of 50 IU/mL (100 RNA copies/mL).
16. The hepatitis viruses transmitted via the fecal-oral route causing acute hepatitis are
a. A and E.
b. B, C, D.
c. A and D.
d. A, B, and C.
17. The highest prevalence of viral hepatitis is found in the USA.
18. Implementation of HBV vaccine has decreased HBV infections.
19. More than 70% of patients with acute hepatitis-C infection do not have symptoms.
20. Patients presenting with symptoms of acute HCV infection usually manifest how long after exposure?
a. 24 to 48 hours
b. 1 to 2 weeks
c. 6 to 8 weeks
d. 3 to 4 months