[MCQ] Acute viral hepatitis- Part 7

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Acute viral hepatitis- Part 7

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Question 1

Acute hepatitis-like clinical events in chronic hepatitis B may be due to ?

A	HDV superinfection
B	Spontaneous HBeAg to anti-HBe seroconversion
C	Spontaneous reactivation
D	All of the above

Question 1 Explanation:

Apart from the above conditions, acute clinical exacerbations of chronic hepatitis B may be due to emergence of a precore mutant

Question 2

The diagnosis of anicteric hepatitis is based on ?

A	S. Aminotransferase levels
B	S. Bilirubin levels
C	S. Alkaline phosphatase levels
D	S. GGT levels

Question 2 Explanation:

The diagnosis of anicteric hepatitis is based on clinical features & on aminotransferase elevations

Question 3

In acute hepatitis, very high serum bilirubin level (20 - 30 mg/ dL) occur in ?

A	Severe disease
B	Glucose-6-phosphate dehydrogenase deficiency
C	Sickle cell anemia
D	All of the above

Question 3 Explanation:

Bilirubin levels >20 mg/dL persisting late into the course of viral hepatitis is associated with severe disease. Patients with underlying hemolytic anemia, like glucose-6-phosphate dehydrogenase deficiency and sickle cell anemia, also have high serum bilirubin levels (>30 mg/dL) due to superimposed hemolysis

Question 4

Which of the following occur transiently in acute viral hepatitis ?

A	Neutropenia
B	Lymphopenia
C	Steatorrhea
D	All of the above

Question 5

Which of the following is characteristically elevated during acute hepatitis A ?

A	Serum IgG
B	Serum IgG
C	Serum IgA
D	Serum IgE

Question 5 Explanation:

A diffuse but mild elevation of the gamma globulin fraction is common during acute viral hepatitis. Serum IgM level is elevated more characteristically during acute hepatitis A.

Question 6

Which of the following antibodies may be present during the acute phase of viral hepatitis ?

A	Rheumatoid factor
B	Nuclear antibody
C	Heterophil antibody
D	All of the above

Question 6 Explanation:

During the acute phase of viral hepatitis, antibodies to smooth muscle and other cell constituents may be present, and low titers of rheumatoid factor, nuclear antibody, and heterophil antibody can also be found. In hepatitis C and D, antibodies to LKM may be found.

Question 7

Which of the following is true in chronic HBV infection ?

A	IgM anti-HBc-positive, IgG anti-HBc-positive
B	IgM anti-HBc-negative, IgG anti-HBc-negative
C	IgM anti-HBc-negative, IgG anti-HBc-positive
D	IgM anti-HBc-positive, IgG anti-HBc-negative

Question 7 Explanation:

IgM anti-HBc may be useful to distinguish between acute or recent infection (IgM anti-HBc-positive) and chronic HBV infection (IgM anti-HBc-negative, IgG anti-HBc-positive).

Question 8

A false-positive test for IgM anti-HBc may be found in patients with ?

A	Glucose-6-phosphate dehydrogenase deficiency
B	High-titer rheumatoid factor
C	Sickle cell anemia
D	All of the above

Question 8 Explanation:

A false-positive test for IgM anti-HBc may be encountered in patients with high-titer rheumatoid factor.

Question 9

Presence of anti-HBs in the presence of HBsAg in patients with acute hepatitis B indicates which of the following ?

A	Fulminant hepatitis
B	Chronicity
C	Imminent HBsAg clearance
D	None of the above

Question 9 Explanation:

Anti-HBs is rarely detectable in the presence of HBsAg in patients with acute hepatitis B. When this happens, its of no recognized clinical significance

Question 10

After hepatitis B vaccination, which is the only serologic marker to appear ?

A	Anti-HBs
B	Anti-HBe
C	Anti-HBc
D	All of the above

Question 10 Explanation:

After immunization with hepatitis B vaccine, which consists of HBsAg alone, anti-HBs is the only serologic marker to appear

Question 11

In chronic hepatitis B, high levels of HBV DNA increase the risk of ?

A	Cirrhosis
B	Hepatic decompensation
C	Hepatocellular carcinoma
D	All of the above

Question 12

Relapsing hepatitis is a feature of ?

A	Acute hepatitis A
B	Acute hepatitis B
C	Acute hepatitis C
D	Hepatitis D superinfection

Question 12 Explanation:

Complications of hepatitis A include relapsing hepatitis appearing weeks to months after apparent recovery from acute hepatitis, cholestatic hepatitis and rarely fulminant hepatitis.

Question 13

Extrahepatic manifestations of HCV include ?

A	Mixed cryoglobulinemia
B	Porphyria cutanea tarda
C	Lichen planus (LP)
D	All of the above

Question 13 Explanation:

Well-accepted extrahepatic manifestations of HCV include pruritus, mixed cryoglobulinemia & necrolytic acral erythema. Frequently associated conditions include porphyria cutanea tarda, leucocytoclastic vasculitis, lichen planus, sicca syndrome & polyarteritis nodosa

Question 14

Fulminant hepatitis is rare in ?

A	Hepatitis A
B	Hepatitis B & D
C	Hepatitis E
D	All of the above

Question 14 Explanation:

Fulminant hepatitis is primarily seen in hepatitis B and D, and hepatitis E. It is rare in hepatitis A

Question 15

Out of the following, fulminant hepatitis is most common in ?

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

Question 15 Explanation:

Hepatitis B accounts for >50% of fulminant cases of viral hepatitis.

Question 16

Fulminant hepatitis is hardly ever seen in ?

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

Question 16 Explanation:

Fulminant hepatitis is hardly ever seen in hepatitis C

Question 17

Likelihood of remaining chronically infected after acute HBV infection is high in all except ?

A	Old
B	Down’s syndrome
C	Chronically hemodialyzed patients
D	HIV infection

Question 17 Explanation:

Likelihood of remaining chronically infected after acute HBV infection is high among neonates, Down’s syndrome, chronically hemodialyzed patients & immunosuppressed patients, including those with HIV infection.

Question 18

Progression of acute to chronic hepatitis is likely if ?

A	HBeAg persists for >3 months
B	HBsAg persists for >6 months
C	AST/ALT do not normalise within 6-12 months
D	All of the above

Question 18 Explanation:

Progression of acute hepatitis to chronic hepatitis is likely if clinical symptoms do not resolve, AST/ ALT, bilirubin and globulin levels fail to normalise within 6-12 months, HBeAg persists for >3 months and HBsAg persists for >6 months

Question 19

Likelihood of remaining chronically infected after acute HCV infection is ?

A	25 - 40 %
B	40 - 60 %
C	65 - 75 %
D	85 - 90 %

Question 19 Explanation:

After acute HCV infection, the likelihood of remaining chronically infected approaches 85-90%.

Question 20

Gianotti-Crosti syndrome is best related to ?

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

Question 20 Explanation:

Gianotti-Crosti syndrome or papular acrodermatitis of childhood refers to hepatitis B that presents with anicteric hepatitis, nonpruritic papular rash of face, buttocks & limbs & lymphadenopathy

Question 21

Hepatitis A vaccines provide adequate protection how many weeks after a primary inoculation ?

A	1 week
B	2 weeks
C	3 weeks
D	4 weeks

Question 21 Explanation:

Formalin-inactivated vaccines made from strains of HAV attenuated in tissue culture are safe, immunogenic, and effectively prevent hepatitis A. Hepatitis A vaccines provide adequate protection beginning 4 weeks after a primary inoculation

Question 22

Hepatitis A vaccine is administered by which route ?

A	Intradermal
B	Subcutenuous
C	Intramuscular
D	Intravenous

Question 22 Explanation:

Hepatitis A vaccine is administered intramuscularly

Question 23

The first vaccine for hepatitis B active immunization was prepared from ?

A	22-nm spherical forms of HBsAg
B	27-nm spherical forms of HBsAg
C	42-nm spherical forms of HBsAg
D	All of the above

Question 23 Explanation:

First vaccine for active immunization (1982) was prepared from purified, noninfectious 22-nm spherical forms of HBsAg derived from plasma of healthy HBsAg carriers.

Question 24

Which of the following is the difference between plasma derived vaccine and genetically engineered Hepatitis B vaccine ?

A	Nonglycosylated
B	Hydrolyzed
C	Oxidized
D	Heat attenuated

Question 24 Explanation:

Plasma-derived Hepatitis B vaccine is prepared from purified, noninfectious 22-nm spherical forms of HBsAg derived from plasma of healthy HBsAg carriers, while genetically engineered Hepatitis B vaccine is derived from recombinant yeast and consists of HBsAg particles that are nonglycosylated but are otherwise indistinguishable from natural HBsAg;

Question 25

Hepatitis B vaccine is administered ?

A	Intradermally
B	Subcuteneously
C	Intramuscularly
D	Intravenously

Question 26

In adults, recommended site of Hepatitis B vaccine is ?

A	Thigh muscle
B	Triceps muscle
C	Deltoid muscle
D	Gluteal muscle

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See all quizzes of Acute viral hepatitis at here:

1.Acute hepatitis-like clinical events in chronic hepatitis B may
be due to ?
A. HDV superinfection
B. Spontaneous HBeAg to anti-HBe seroconversion
C. Spontaneous reactivation
D. All of the above

2. The diagnosis of anicteric hepatitis is based on ?
A. S. Aminotransferase levels
B. S. Bilirubin levels
C. S. Alkaline phosphatase levels
D. S. GGT levels

3. In acute hepatitis, very high serum bilirubin level (20 – 30 mg/
dL) occur in ?
A. Severe disease
B. Glucose-6-phosphate dehydrogenase deficiency
C. Sickle cell anemia
D. All of the above

4. Which of the following occur transiently in acute viral
hepatitis ?
A. Neutropenia
B. Lymphopenia
C. Steatorrhea
D. All of the above

5. Which of the following is characteristically elevated during
acute hepatitis A ?
A. Serum IgG
B. Serum IgM
C. Serum IgA
D. Serum IgE

4. Which of the following antibodies may be present during the
acute phase of viral hepatitis ?
A. Rheumatoid factor
B. Nuclear antibody
C. Heterophil antibody
D. All of the above

5. If levels of HBsAg are too low to be detected during acute HBV
infection, which of the following establishes its diagnosis ?
A. IgM anti-HBc
B. IgG anti-HBc
C. IgM & IgG anti-HBc
D. HBeAg

6. Which of the following is true in chronic HBV infection ?
A. IgM anti-HBc-positive, IgG anti-HBc-positive
B. IgM anti-HBc-negative, IgG anti-HBc-negative
C. IgM anti-HBc-negative, IgG anti-HBc-positive
D. IgM anti-HBc-positive, IgG anti-HBc-negative

7. A false-positive test for IgM anti-HBc may be found in patients
with ?
A. Glucose-6-phosphate dehydrogenase deficiency
B. High-titer rheumatoid factor
C. Sickle cell anemia
D. All of the above

8. Presence of anti-HBs in the presence of HBsAg in patients with
acute hepatitis B indicates which of the following ?
A. Fulminant hepatitis

B. Chronicity
C. Imminent HBsAg clearance
D. None of the above

9. After hepatitis B vaccination, which is the only serologic marker
to appear ?
A. Anti-HBs
B. Anti-HBe
C. Anti-HBc
D. All of the above

10.In chronic hepatitis B, high levels of HBV DNA increase the
risk of ?
A. Cirrhosis
B. Hepatic decompensation
C. Hepatocellular carcinoma
D. All of the above

11. Relapsing hepatitis is a feature of ?
A. Acute hepatitis A
B. Acute hepatitis B
C. Acute hepatitis C
D. Hepatitis D superinfection

12. Extrahepatic manifestations of HCV include ?
A. Mixed cryoglobulinemia
B. Porphyria cutanea tarda
C. Lichen planus (LP)
D. All of the above

13.Fulminant hepatitis is rare in ?
A. Hepatitis A
B. Hepatitis B & D
C. Hepatitis E
D. All of the above

14. Out of the following, fulminant hepatitis is most common in ?
A. Hepatitis A

B. Hepatitis B
C. Hepatitis C
D. Hepatitis E
15. Fulminant hepatitis is hardly ever seen in ?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis E

16. Likelihood of remaining chronically infected after acute HBV
infection is high in all except ?
A. Old
B. Down’s syndrome
C. Chronically hemodialyzed patients
D. HIV infection

17. Progression of acute to chronic hepatitis is likely if ?
A. HBeAg persists for >3 months
B. HBsAg persists for >6 months
C. AST/ALT do not normalise within 6-12 months
D. All of the above

18. Likelihood of remaining chronically infected after acute HCV
infection is ?
A. 25 – 40 %
B. 40 – 60 %
C. 65 – 75 %
D. 85 – 90 %

19. Gianotti-Crosti syndrome is best related to ?
A. Hepatitis A
B. Hepatitis B
C. Hepatitis C
D. Hepatitis E

19. Hepatitis A vaccines provide adequate protection how many
weeks after a primary inoculation ?
A. 1 week

B. 2 weeks
C. 3 weeks
D. 4 weeks

20. Hepatitis A vaccine is administered by which route ?
A. Intradermal
B. Subcutenuous
C. Intramuscular
D. Intravenous

21. The first vaccine for hepatitis B active immunization was
prepared from ?
A. 22-nm spherical forms of HBsAg
B. 27-nm spherical forms of HBsAg
C. 42-nm spherical forms of HBsAg
D. All of the above

22. Which of the following is the difference between plasma
derived vaccine and genetically engineered Hepatitis B
vaccine ?
A. Nonglycosylated
B. Hydrolyzed
C. Oxidized
D. Heat attenuated

23. Hepatitis B vaccine is administered ?
A. Intradermally
B. Subcuteneously
C. Intramuscularly
D. Intravenously
2In adults, recommended site of Hepatitis B vaccine is ?
Harrison’s 18th Ed. 2555
A. Thigh muscle
B. Triceps muscle
C. Deltoid muscle
D. Gluteal muscle

[MCQ] Acute viral hepatitis- Part 7

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Acute viral hepatitis- Part 7

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