Hepatitis B

Question 1

HBV seen in electron microscope

Answer 1

Dane particle

Question 2

1st antigen to appear ( 1-12 weeks) in HBV

Answer 2

HBsAg ( Australian antigen) - SGPT - jaundice
disappear in reverse order

Question 3

never appear in blood antigen in HBV

Answer 3

HBcAg

Question 4

marker of replication or infectivity

Answer 4

HBeAg

Question 5

most common route of transmission

Answer 5

Percutaneous exposure

Question 6

mc cause of transfusion associate hepatitis

Answer 6

Hepatitis Bombay

Question 7

for transfusion blood tested for

Answer 7

HBV ( HBsAg)
HCV (EIA anti-HCV antibody) , PCR HCV RNA
HIV ( ELISA HIV, PCR HIV for window period )
syphilis ( FTA-ABS)
Malaria ( HRP-2 dipstic test)

Question 8

on PS Malaria falciparum & babesia microti

Answer 8

malaria : banana shape & maltese cross appearance
babesia microti : cross appearance
vector : Ixodes scapularis
Mx : Atovaquone and Azithral

Question 9

Mx of Mother to baby transmission of HBV

Answer 9

HBIg immunoglobulin < 12 hr to child ( passive immunity) + HBV vaccine 3 dose ( 0,6,10 or 14 week) ( active )

Question 10

accidental needle stick injury Mx

Answer 10

30% chance of transmission
HBIg IM ASAP within 6hr
1st test HBV PCR
If vaccinated chek HBsAg antigrn titer > 10u NP

Question 11

Trigger development of HCC

Answer 11

HBxAd : CD95 inhibitor extrinsic pathway of apoptosis

Question 12

Dx of HBV

Answer 12

HBsAg viral load : > 2* 10to4 IU/ml + 2*SGPT
Mx : Tenofovir / Entecavir

Question 13

S.Billirubin increase ( unconjugated )
SGOT increase
SGPT increase
SAP normal

Answer 13

Hepatocellular carcinoma

Question 14

S.Billirubin increase ( conjugated )
SGOT normal
SGPT normal
SAP more increase

Answer 14

Obstructive jaundice

Question 15

What persist in chronic HBV

Answer 15

HBsAg & IgG anti HBc

Question 16

S.Billirubin increase ( unconjugated )
SGOT normal
SGPT normal
SAP normal
splenomegaly & anemia

Answer 16

hemolytic anemia

Question 17

USG in HBV

Answer 17

Starry Sky Liver appearance

Question 18

HBsAg + Anti HBc IgM + HBeAg +

Answer 18

Acute HBV

Question 19

HBsAg + Anti HBc IgC + HBeAg +

Answer 19

chronic HBV

Question 20

Anti HBc IgG + Anti HBs +

Answer 20

Recovery

Question 21

Anti HBc IgM +

Answer 21

Gap period

Question 22

AntiHBs + >10 IU/ml

Answer 22

VACCINATED

Question 23

Anti HBc IgG +

Answer 23

low level carrier/ remote infection

Question 24

chronic HBV Dx & Mx

Answer 24

PCR HBV DNA > 2*10to4 IU DNA/ml
Mx : tenofovir 300mg OD for 48 weeks

Question 25

compensated cirrhosis pt

Answer 25

PCR HBV DNA > 2*10to3 IU DNA/ml Mx : tenofovir 300mg OD for 48 weeks

Question 26

Mx of HBV

Answer 26

High glucose diet nausea : Itopride IV ( 10% dextrose )