Question 1

Which of the following is a form of infectious (rather than serum)hepatitis?&#10;A) hepatitis A&#10;B) hepatitis B&#10;C) hepatitis C&#10;D) hepatitis D

Accepted Answer

Hepatitis A and hepatitis E are forms of infectious hepatitis; they are spread largely by the fecal-oral route,are associated with poor sanitary conditions,are highly contagious,occur in outbreaks as well as sporadically,and cause self-limited hepatitis only.Hepatitis B,hepatitis C,and hepatitis D are forms of serum hepatitis,are spread largely by parenteral routes and less commonly by intimate or sexual exposure,and are not highly contagious but instead occur sporadically and rarely cause outbreaks.

Question 2

Which of the following is the most reliable prognostic factor in acute hepatic failure due to hepatitis?&#10;A) changes in personality&#10;B) the degree of prolongation of prothrombin time&#10;C) serum aminotransferase levels&#10;D) viral titers

Accepted Answer

Prolongation of the prothrombin time is the most reliable prognostic factor.The initial symptoms,such as changes in personality,aggressive behavior,and abnormal sleep patterns,may be subtle or misunderstood.Serum aminotrAnswerferase levels and viral titers have little prognostic value and often decrease with worsening hepatic failure.

Question 3

Which of the following tests is the best way to screen for problems before dental treatment of an alcoholic patient?&#10;A) bilirubin total&#10;B) alkaline phosphatase total&#10;C) LDH total&#10;D) a complete blood count (CBC)

Accepted Answer

A CBC with differential and determinations of AST and ALT,bleeding time,thrombin time,and prothrombin time are sufficient to screen for potential problems.Abnormal laboratory values,on a background of suggestive findings on the clinical examination or a positive history,constitute the basis for referral to a physician for definitive diagnosis and treatment.

Question 4

Which of the following is associated with immunity to hepatitis B?&#10;A) HBsAg&#10;B) HBcAg&#10;C) HBeAg&#10;D) Anti-HBs&#10;E) Anti-HBe

Accepted Answer

Anti-HBs is a long-lasting antibody that is associated with immunity.Generally,HBV DNA and HBeAg begin to fall at the onset of illness and may be undetectable at the time of peak clinical illness.HBsAg becomes undetectable and anti-HBs appears during recovery,several weeks to months after loss of HBsAg.

Question 5

Which of the following is the most common means of transmission of hepatitis C?&#10;A) maternal-infant&#10;B) sexual exposure&#10;C) injection drug use&#10;D) needlestick accidents

Accepted Answer

Current studies of acute hepatitis C indicate that more than 60% of cases are attributable to injection drug use; 15% to 20% to sexual exposure; and only a small proportion to maternal-infant spread,needlestick accidents,and iatrogenic causes.Approximately 10% of cases are not associated with any history of potential exposure and remain unexplained.

Question 6

Which of the following types of breath odor is associated with liver failure?&#10;A) sweet, musty&#10;B) breadlike&#10;C) ammonia&#10;D) garlic

Accepted Answer

A sweet,musty odor to the breath is associated with liver failure,as is jaundiced mucosal tissue.

Question 7

Which of the following is thought to be the major factor in the pathogenesis of liver injury?&#10;A) antibody-dependent cellular cytotoxicity&#10;B) proinflammatory cytokines&#10;C) cytotoxic T cell responses&#10;D) natural killer cell activity

Accepted Answer

The timing and histologic appearance of hepatocyte injury in viral hepatitis suggest that immune responses,particularly cytotoxic T cell responses to viral antigens expressed on hepatocyte cell membranes,may be the major effectors of injury.Other proinflammatory cytokines,natural killer cell activity,and antibody-dependent cellular cytotoxicity also may play modulating roles in cell injury and inflammation during acute viral hepatitis infection.

Question 8

Which of the following is true of the pathophysiology of alcoholic liver disease?&#10;A) Fatty liver is not reversible.&#10;B) Alcoholic hepatitis may be fatal if damage is widespread.&#10;C) In some patients with cirrhosis, blood from bleeding ulcers and esophageal varices is incompletely metabolized to ammonia.&#10;D) a and b&#10;E) b and c

Accepted Answer

Fatty liver is considered completely reversible.For the most part,alcoholic hepatitis is considered a reversible condition; however,it can be fatal if damage is widespread.In some patients with cirrhosis,blood is metabolized to ammonia,which travels to the brain and contributes to encephalopathy.

Question 9

Which of the following is true regarding prevaccination screening and booster doses of hepatitis B vaccine?&#10;A) Prevaccination screening and booster doses are recommended for all persons receiving the hepatitis B vaccination.&#10;B) Prevaccination screening is not recommended; however, booster doses are recommended for all persons receiving the hepatitis B vaccination.&#10;C) Prevaccination screening is not recommended except for adults in high-risk groups. Booster doses are not routinely recommended but may be appropriate for persons at high risk if titers of anti-HBs fall below what is considered protective.&#10;D) Neither prevaccination screening, nor booster doses of hepatitis B vaccine are recommended for anyone.

Accepted Answer

Prevaccination screening for anti-HBs is not recommended except in adults in high-risk groups.Postvaccination testing for anti-HBs to document seroconversion is not recommended routinely except in persons whose subsequent clinical management depends on knowledge of their immune status,particularly health care and public safety workers.At present,booster doses are not recommended but may be appropriate for persons at high risk if titers of anti-HBs fall below what is considered protective (10 IU/mL).Current guidelines published by the Centers for Disease Control and Prevention (CDC)Advisory Committee on Immunization Practices recommend booster doses only for persons who did not respond to the primary vaccine series.

Question 10

Which of the following is the most common means by which hepatitis A is spread?&#10;A) consumption of shellfish from contaminated waterways&#10;B) fecal contamination of food or water&#10;C) direct person-to-person exposure&#10;D) blood transfusions

Accepted Answer

Investigation of the sources of infection for hepatitis A reveals that most cases are due to direct person-to-person exposure and,to a lesser extent,to direct fecal contamination of food or water.Consumption of shellfish from contaminated waterways is a well-known but quite uncommon meAnswer of acquiring hepatitis A.Rare instances of hepatitis A being spread by blood trAnswerfusions and administration of pooled plasma products have been described.

Question 11

Which of the following is true regarding the diagnosis of acute viral hepatitis?&#10;A) Acute viral hepatitis is marked by a prominent fibrosis observed during histologic evaluation.&#10;B) Immunohistochemical stains for hepatitis antigens are positive during the acute disease.&#10;C) There are reliably distinctive features in the liver that separate the five viral forms of acute hepatitis from one another.&#10;D) Serologic tests are adequate for the diagnosis of acute viral hepatitis, so liver biopsy is not recommended unless the diagnosis remains unclear and a therapeutic decision is needed.

Accepted Answer

The answer of Which of the following is true regarding...

Question 12

(A/An)_______________ syndrome develops during the preicteric phase in approximately 10% to 20% of patients with acute hepatitis.&#10;A) chronic fatigue&#10;B) irritable bowel&#10;C) serum sickness-like&#10;D) aspirin triad syndrome

Accepted Answer

The answer of (A/An)_______________ syndrome develops during the preicteric phase...

Question 13

Which of the following hepatitis viruses is second most likely (following hepatitis B)to be transmitted occupationally to a dental healthcare worker?&#10;A) HAV&#10;B) HCV&#10;C) HEV&#10;D) non-A-E

Accepted Answer

The answer of Which of the following hepatitis viruses is...

Question 14

According to CDC guidelines,what should be done first if a vaccinated health care worker sustains a needlestick or puncture wound involving exposure to blood from a patient known to be HBsAg-positive?&#10;A) Nothing, because the health care worker has already been vaccinated.&#10;B) The health care worker should be tested for an adequate titer of anti-HBs if those levels are unknown.&#10;C) The health care worker should immediately receive an injection of HBIG.&#10;D) The health care worker should immediately receive an injection of the hepatitis B vaccine as a booster dose.

Accepted Answer

The answer of According to CDC guidelines,what should be done...

Question 15

Chronic active hepatitis B is diagnosed by the presence of ______ in blood serum.&#10;A) HBsAg&#10;B) HBcAg&#10;C) HBeAg&#10;D) a, b, and c&#10;E) a and c

Accepted Answer

The answer of Chronic active hepatitis B is diagnosed by...

Deck 10: Liver Disease