[MCQ] Acute viral hepatitis- Part 5

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Acute viral hepatitis- Part 5

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Congratulations - you have completed Acute viral hepatitis- Part 5. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Which of the following ORF in Hepatitis E virus genome encodes the nonstructural, enzymatic activities required for viral replication ?

A	ORF1
B	ORF2
C	ORF3
D	All of the above

Question 1 Explanation:

Largest of three ORFs, ORF1 encodes the nonstructural, enzymatic activities required for viral replication

Question 2

In HEV, which of the following genes encode the nucleocapsid protein ?

A	ORF1
B	ORF2
C	ORF3
D	All of the above

Question 2 Explanation:

The middle-sized open reading frame 2 (ORF2) gene in HEV encodes the nucleocapsid protein. ORF1 encodes nonstructural proteins involved in virus replication. The smallest ORF3, encodes a structural protein whose function remains undetermined.

Question 3

ORF gene relates to ?

A	Hepatitis A
B	Hepatitis B
C	Hepatitis C
D	Hepatitis E

Question 3 Explanation:

HEV has three open reading frames (ORF) genes.

Question 4

Which of the following acts as an animal reservoir contributing to the perpetuation of HEV ?

A	Swine
B	Bird
C	Fish
D	Dog

Question 4 Explanation:

Contributing to the perpetuation of HEV are animal reservoirs, most notably in swine.

Question 5

Which of the following best relates to HEV ?

A	Flaviviridae
B	Hepeviridae
C	Rhabdoviridae
D	Rhabdoviridae

Question 5 Explanation:

HEV was the first member to be identified in the Hepeviridae family.

Question 6

Which of the following about HEV is false ?

A	HEV replicates in cytoplasm
B	Genotypes 1 and 2 are human viruses
C	Genotypes 3 and 4 are swine viruses
D	None of the above

Question 6 Explanation:

HEV replicates in cytoplasm. Four genotypes of HEV have been categorized into two major groups. Genotypes 1 and 2 are human viruses that cause epidemic hepatitis with waterborne and fecal-oral transmission. Genotypes 3 and 4 are swine viruses.

Question 7

Which of the following about HEV infection is false ?

A	HEV RNA is detectable in stool during incubation period
B	HEV RNA is detectable in serum during incubation period
C	IgM antibody is undetectable during recovery
D	None of the above

Question 7 Explanation:

Both IgM anti-HEV and IgG anti-HEV appear early during acute infection, but both fall rapidly after acute infection, reaching low levels within 9 - 12 months

Question 8

Incubation period of acute hepatitis E infection is ?

A	1 to 2 weeks
B	2 to 4 weeks
C	3 to 8 weeks
D	6 to 12 weeks

Question 8 Explanation:

Acute hepatitis E has an incubation period of 3 to 8 weeks.

Question 9

Average case fatality rate in acute HEV infections is ?

A	0 %
B	2 %
C	3 %
D	5 %

Question 10

Clinical features of autochthonous hepatitis E include all except ?

A	Disease rates highest among older adults
B	Hepatitis E is preventable by vaccination
C	No neurologic complications
D	Ribavirin, peginterferon indicated

Question 10 Explanation:

In endemic, or autochthonous hepatitis E, the average age was more than 60 years, and men outnumbered women by at least 3 to 1. Hepatitis E is preventable by vaccination. Autochthonous HEV infection is usually subclinical and mild. Autochthonous hepatitis E has frequent serious complications, including “acute-on-chronic” liver failure, neurologic disorders (polyradiculopathy, the GBS, Bell’s palsy, peripheral neuropathy, ataxia, and mental confusion), and chronic hepatitis. Chronic hepatitis E is also susceptible to antiviral therapy (peginterferon, ribavirin, or a combination of two)

Question 11

Chronic infection in Hepatitis E has been identified almost exclusively among ?

A	Pre-existing liver disease
B	Blood transfusion recepients
C	Pork eaters
D	Immunocompromised persons

Question 11 Explanation:

Chronic HEV infection has been identified almost exclusively among immunocompromised persons (organtransplant recipients, patients receiving cancer chemotherapy, and HIV-infected persons). Blood transfusion is a potential but rare route of HEV transmission. Chronic hepatitis E is characterized by the persistence of HEV RNA in serum & stool, accompanied by fluctuating, mild-to-moderate elevations in serum ALT levels and low or moderate titers of IgG and IgM anti-HEV antibodies

Question 12

Which of the following statements is false ?

A	Hepatitis B virus is not directly cytopathic
B	HBcAg invites cytolytic T cells to destroy HBV-infected hepatocytes
C	Inactive hepatitis B carriers can have normal liver histology
D	None of the above

Question 13

Which of the following statements is false ?

A	Patients with defects in cellular immune competence are more likely to remain chronically infected with HBV
B	Chronic HBV infection can occur in the absence of serum hepatitis B e antigen (HBeAg)
C	Chronic HBV infection can occur in the absence of serum hepatitis B e antigen (HBeAg)
D	None of the above

Question 14

Which of the following is associated with a more severe outcome of HBV infection ?

A	Infection with precore genetic mutants of HBV
B	Infection with precore genetic mutants of HBV
C	In liver transplantation for end-stage chronic hepatitis B
D	All of the above

Question 15

HBV infection in neonatal period is associated with all except ?

A	Acquisition of immunologic tolerance to HBV
B	Absence of acute-hepatitis illness
C	Absence of acute-hepatitis illness
D	Absence of acute-hepatitis illness

Question 15 Explanation:

Neonatally acquired HBV infection can may culminate into cirrhosis & hepatocellular carcinoma

Question 16

HBV infection acquired during adolescence or early adulthood is associated with all except ?

A	Robust host-immune response
B	Acute hepatitis-like illness
C	Failure to recover is the exception
D	Chronicity is common

Question 16 Explanation:

Chronicity is uncommon and risk of hepatocellular carcinoma is very low.

Question 17

Which of the following HLA allele has been linked with self limited hepatitis C ?

A	HLA-B*1501
B	HLA-B*5701
C	Single nucleotide polymorphism T allele at IL28B locus
D	C/C haplotype of the IL28B gene

Question 17 Explanation:

C/C haplotype of the IL28B gene has been linked with self-limited hepatitis C

Question 18

Which of the following plays a pathogenetic role in the extrahepatic manifestations of acute hepatitis B ?

A	Cytopathic role of virus
B	Immune complex - mediated tissue damage
C	Cryoprecipitable immune complexes
D	All of the above

Question 18 Explanation:

Immune complex - mediated tissue damage plays a pathogenetic role in the extrahepatic manifestations of acute hepatitis B.

Question 19

Which of the following is an extrahepatic manifestation of hepatitis B ?

A	Glomerulonephritis with nephrotic syndrome
B	Polyarteritis nodosa
C	Essential mixed cryoglobulinemia (EMC)
D	All of the above

Question 20

Which of the following is the pathognomonic manifestation of HCV infection ?

A	Necrolytic acral erythema
B	Porphyria cutanea tarda
C	Leucocytoclastic vasculitis
D	Lichen planus (LP)

Question 21

Mixed cryoglobulinemia (MC) is associated with which of the following ?

A	HAV
B	HCV
C	HDV
D	HEV

Question 21 Explanation:

Mixed cryoglobulinemia (MC) is unequivocally associated with HCV.

Question 22

Which type of cryoglobulinemia is associated with lymphoproliferative diseases ?

A	Types I
B	Types II
C	Types III
D	Any of the above

Question 22 Explanation:

Type I cryoglobulinemia is monoclonal & associated with lymphoproliferative diseases (multiple myeloma, Waldenström macroglobulinemia). Types II & III are mixed & polyclonal cryoglobulinemias and are associated with autoimmune disorders, viral infections, & chronic liver disease (Brouet classification)

Question 23

Classic triad of cryoglobulinemic syndrome includes all except ?

A	Purpura
B	Arthralgias
C	Weakness
D	Acrocyanosis

Question 23 Explanation:

Classic triad of cryoglobulinemic syndrome consists of purpura, arthralgias & weakness. Others are glomerulonephritis, peripheral neuropathy, generalized vasculitis, livedo reticularis, ischemic ulcers, acrocyanosis and hemorrhagic bullae.

Question 24

Cryoglobulins are immunoglobulins that precipitate at temperatures below ?

A	37°C
B	36°C
C	35°C
D	34°C

Question 24 Explanation:

Cryoglobulins are immunoglobulins that precipitate at temperatures below 37°C and re-dissolve with warming

Question 25

Morphologic lesions of viral hepatitis are all except ?

A	Panlobular mononuclear cells infiltration
B	Hepatic cell necrosis
C	Cholestasis
D	Atrophy of Kupffer cells

Question 25 Explanation:

Typical morphologic lesions of all types of viral hepatitis are panlobular infiltration with mononuclear cells, hepatic cell necrosis, Kupffer cells hyperplasia & variable cholestasis. Hepatic cell regeneration is present

Question 26

Panlobular mononuclear infiltration in viral hepatitis consists “primarily” of ?

A	Plasma cells
B	Small lymphocytes
C	Large lymphocytes
D	Eosinophils

Question 26 Explanation:

Panlobular mononuclear infiltration in viral hepatitis consists “primarily” of small lymphocytes. Plasma cells & eosinophils are present occasionally

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See all quizzes of Acute viral hepatitis at here:

1.Which of the following ORF in Hepatitis E virus genome
encodes the nonstructural, enzymatic activities required for
viral replication ?
A. ORF1
B. ORF2
C. ORF3
D. All of the above

2. In HEV, which of the following genes encode the nucleocapsid
protein ?
A. ORF1
B. ORF2
C. ORF3
D. All of the above

3. ORF gene relates to ?
A. Hepatitis A
B. Hepatitis B

C. Hepatitis C
D. Hepatitis E

4. Which of the following acts as an animal reservoir contributing
to the perpetuation of HEV ?
A. Swine
B. Bird
C. Fish
D. Dog

5. Which of the following best relates to HEV ?
A. Flaviviridae
B. Hepeviridae
C. Rhabdoviridae
D. Arenaviridae

6. Which of the following about HEV is false ?
A. HEV replicates in cytoplasm
B. Genotypes 1 and 2 are human viruses
C. Genotypes 3 and 4 are swine viruses
D. None of the above

7. Which of the following about HEV infection is false ?
A. HEV RNA is detectable in stool during incubation period
B. HEV RNA is detectable in serum during incubation period
C. IgM antibody is undetectable during recovery
D. None of the above

8. Incubation period of acute hepatitis E infection is ?A. 1 to 2 weeks
B. 2 to 4 weeks
C. 3 to 8 weeks
D. 6 to 12 weeks

9. Average case fatality rate in acute HEV infections is ?
A. 0 %
B. 2 %
C. 3 %
D. 5 %

10. Clinical features of autochthonous hepatitis E include all
except ?
A. Disease rates highest among older adults
B. Hepatitis E is preventable by vaccination
C. No neurologic complications
D. Ribavirin, peginterferon indicated

11. Chronic infection in Hepatitis E has been identified almost
exclusively among ?
A. Pre-existing liver disease
B. Blood transfusion recepients
C. Pork eaters
D. Immunocompromised persons

12. Which of the following statements is false ?
A. Hepatitis B virus is not directly cytopathic
B. HBcAg invites cytolytic T cells to destroy HBV-infected
hepatocytes
C. Inactive hepatitis B carriers can have normal liver histology
D. None of the above
13. Which of the following statements is false ?
A. Patients with defects in cellular immune competence are
more likely to remain chronically infected with HBV
B. Chronic HBV infection can occur in the absence of serum
hepatitis B e antigen (HBeAg)
C. Most characteristic histologic feature of chronic HBV
infection is “ground-glass hepatocyte” due to intracellular
accumulation of HBsAg
D. None of the above
14. Which of the following is associated with a more severe
outcome of HBV infection ?
A. Infection with precore genetic mutants of HBV
B. Concomitant HDV and HBV infections
C. In liver transplantation for end-stage chronic hepatitis B
D. All of the above
15. HBV infection in neonatal period is associated with all except ?
A. Acquisition of immunologic tolerance to HBV

B. Absence of acute-hepatitis illness
C. Almost invariable establishment of chronic infection
D. Never go into cirrhosis & hepatocellular carcinoma

16. HBV infection acquired during adolescence or early adulthood
is associated with all except ?
A. Robust host-immune response
B. Acute hepatitis-like illness
C. Failure to recover is the exception
D. Chronicity is common
17. Which of the following HLA allele has been linked with self
limited hepatitis C ?
A. HLA-B*1501
B. HLA-B*5701
C. Single nucleotide polymorphism T allele at IL28B locus
D. C/C haplotype of the IL28B gene
C/C haplotype of the IL28B gene has been linked with self-limited hepatitis C.
18. Which of the following plays a pathogenetic role in the
extrahepatic manifestations of acute hepatitis B ?

A. Cytopathic role of virus
B. Immune complex – mediated tissue damage
C. Cryoprecipitable immune complexes
D. All of the above

19. Which of the following is an extrahepatic manifestation of
hepatitis B ?
A. Glomerulonephritis with nephrotic syndrome
B. Polyarteritis nodosa
C. Essential mixed cryoglobulinemia (EMC)
D. All of the above
20. Which of the following is the pathognomonic manifestation of
HCV infection ?
A. Necrolytic acral erythema
B. Porphyria cutanea tarda
C. Leucocytoclastic vasculitis
D. Lichen planus (LP)

21. Mixed cryoglobulinemia (MC) is associated with which of the
following ?
A. HAV
B. HCV
C. HDV

D. HEV

22. Which type of cryoglobulinemia is associated with
lymphoproliferative diseases ?
A. Types I
B. Types II
C. Types III
D. Any of the above

23. Classic triad of cryoglobulinemic syndrome includes all
except ?
A. Purpura
B. Arthralgias
C. Weakness
D. Acrocyanosis

24. Cryoglobulins are immunoglobulins that precipitate at
temperatures below ?
A. 37°C
B. 36°C
C. 35°C
D. 34°C

24. Morphologic lesions of viral hepatitis are all except ?
A. Panlobular mononuclear cells infiltration
B. Hepatic cell necrosis
C. Cholestasis
D. Atrophy of Kupffer cells

25. Panlobular mononuclear infiltration in viral hepatitis consists
“primarily” of ?
A. Plasma cells
B. Small lymphocytes
C. Large lymphocytes
D. Eosinophils

Acute viral hepatitis

[MCQ] Acute viral hepatitis- Part 5

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Acute viral hepatitis- Part 5

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