[MCQ] Chronic hepatitis- Part 4

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Chronic hepatitis- Part 3

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Congratulations - you have completed Chronic hepatitis- Part 3. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Interferon therapy results in activation of ?

A	Cytokines
B	Chemokines
C	JAKSTAT signal transduction pathway
D	All of the above

Question 1 Explanation:

Interferon therapy results in activation of the JAKSTAT signal transduction pathway, which results in the intracellular elaboration of genes & their protein products with antiviral properties. Hepatitis C proteins inhibit JAK-STAT signaling pathway, and exogenous interferon restores expression of interferon-stimulated genes and their antiviral effects

Question 2

The current standard treatment of chronic hepatitis C is ?

A	PEG IFN
B	Ribavirin
C	PEG IFN + Ribavirin
D	All of the above

Question 2 Explanation:

The current standard treatment of chronic hepatitis C is the combination of long acting pegylated IFN (PEG IFN) and ribavirin

Question 3

Which of the following variable does not correlate favourably in the IFN-based treatment of chronic hepatitis C ?

A	Genotypes 2 and 3
B	Genotypes 2 and 3
C	Low baseline HCV RNA level
D	Histologically mild hepatitis

Question 3 Explanation:

Patient variables that tend to correlate with sustained virologic responsiveness to IFN-based therapy include favorable genotype (genotypes 2 and 3 as opposed to genotypes 1 and 4), low baseline HCV RNA level (<2 million copies/mL, which is equivalent to 800,000 IU/ml), histologically mild hepatitis and minimal fibrosis, age <40, absence of obesity as well as insulin resistance and type-II diabetes mellitus, and female gender. Patients with cirrhosis respond less favourably

Question 4

Duration of IFN-ribavirin therapy have in patients with genotype 1 should last for ?

A	12 weeks
B	12 weeks
C	48 weeks
D	72 weeks

Question 5

Duration of IFN-ribavirin therapy have in patients with genotype 2 and 3 should last for

A	12 weeks
B	24 weeks
C	48 weeks
D	48 weeks

Question 5 Explanation:

Combination IFN-ribavirin therapy in chronic hepatitis C with genotype 1 should for 48 weeks, while in those with genotypes 2 and 3, a 24-week course of therapy suffices

Question 6

Which of the following is relevant for patients treated with PEG IFN and ribavirin ?

A	SLCO1B1
B	HLA-B*1501
C	IL15
D	IL28B

Question 6 Explanation:

In studies of patients treated with PEG IFN and ribavirin, variants of the IL28B SNP that code for IFN-3 correlate significantly with responsiveness. Patients homozygous for the C allele at this locus have the highest frequency of achieving an SVR (80%), those homozygous for the T allele at this locus are least likely to achieve an SVR (25%), and those heterozygous at this locus (C/T) have an intermediate level of responsiveness (SVRs in 35%)

Question 7

The most pronounced side effect of ribavirin therapy is ?

A	Seizure
B	Agranulocytosis
C	Hemolysis
D	All of the above

Question 7 Explanation:

The most pronounced side effect of ribavirin therapy is hemolysis.

Question 8

Which of the following is a side effect of ribavirin therapy ?

A	Pruritus
B	Gout
C	Anemia
D	All of the above

Question 9

Halflife in serum of Hepatitis C virion is ?

A	2 - 3 hours
B	2 - 3 days
C	2 - 3 monhs
D	2 - 3 years

Question 9 Explanation:

Despite a Hepatitis C virion halflife in serum of only 2 - 3 hours, the level of HCV is maintained by a high replication rate of 1012 hepatitis C virions per day

Question 10

Elimination time of PEG IFN is how many times longer than standard IFN ?

A	Three times
B	Three times
C	Seven times
D	Nine times

Question 10 Explanation:

For the treatment of chronic hepatitis C, standard IFNs have now been supplanted by PEG IFNs and these have elimination times up to sevenfold longer than standard IFNs

Question 11

Standard indication for antiviral therapy of chronic hepatitis C is ?

A	Detectable HCV RNA (with or without elevated ALT
B	Portal/bridging fibrosis on liver biopsy
C	Moderate to severe hepatitis on liver biopsy
D	All of the above

Question 12

Antiviral therapy is not recommended in which of the following patients of chronic hepatitis C ?

A	Age > 60 years
B	Mild hepatitis on liver biopsy
C	Persons with severe renal insufficiency
D	All of the above

Question 13

Which of the following patients of chronic hepatitis C are not candidates for IFN-based antiviral therapy ?

A	Decompensated cirrhosis
B	Pregnancy
C	Contraindications to use of interferon or ribavirin
D	All of the above

Question 13 Explanation:

Patients with decompensated cirrhosis are not candidates for IFN-based antiviral therapy but should be referred for liver transplantation. Interferons are antiproliferative and ribavirin is teratogenic.

Question 14

Duration of PEG IFN / ribavirin therapy in chronic hepatitis C of genotypes 1 and 4 is ?

A	12 weeks
B	24 weeks
C	24 weeks
D	72 weeks

Question 15

Duration of PEG IFN / ribavirin therapy in chronic hepatitis C of genotypes 2 and 3 is ?

A	12 weeks
B	24 weeks
C	48 weeks
D	72 weeks

Question 16

Dose of PEG IFN -2a is ?

A	180 µg daily subcutaneously
B	180 µg weekly subcutaneously
C	180 µg daily intramuscularly
D	180 µg weekly intramuscularly

Question 16 Explanation:

Two PEG IFNs are available: PEG IFN -2b and -2a. PEG IFN -2a is given 180 µg weekly subcutaneously.

Question 17

Dose of PEG IFN -2b is ?

A	0.5 µg / kg weekly subcutaneously
B	1.5 µg / kg weekly subcutaneously
C	2.5 µg / kg weekly subcutaneously
D	3.5 µg / kg weekly subcutaneously

Question 17 Explanation:

PEG IFN -2b is given 1.5 µg / kg weekly subcutaneously

Question 18

Which of the following is recommended for the success of therapy with PEG IFN / ribavirin in chronic hepatitis C ?

A	HCV genotype should be determined prior to therapy
B	Measure HCV RNA at 12 weeks
C	Pretreatment liver biopsy
D	All of the above

Question 19

Which of the following is advocated in those who have not responded to treatment with PEG IFN / ribavirin in chronic hepatitis C ?

A	Longer duration of treatment
B	Higher doses of either PEG IFN, ribavirin, or both
C	Switching to a different IFN preparation
D	All of the above

Question 19 Explanation:

For those who have not responded to treatment with PEG IFN / ribavirin in chronicn hepatitis C, following may be tried : longer duration of treatment; higher doses of either PEG IFN, ribavirin, or both and switching to a different IFN preparation. However, none of these approaches achieves more than a marginal benefit.

Question 20

Which of the following associated with hepatitis C may respond to antiviral therapy ?

A	Essential mixed cryoglobulinemia
B	Porphyria cutanea tarda
C	Lichen planus
D	All of the above

Question 21

Which of the following drug is beneficial in acute hepatitis C ?

A	Lamivudine
B	Interferon monotherapy
C	Ribavirin
D	Glucocorticoid

Question 21 Explanation:

In acute hepatitis C, interferon monotherapy (3 million units SC three times a week) is beneficial. Long-acting pegylated interferon plus ribavirin is superior to interferon monotherapy.

Question 22

In fulminant hepatitis, which of the following has been shown to improve survival ?

A	Glucocorticoid therapy
B	Exchange transfusion
C	Prophylactic antibiotic coverage
D	Extracorporeal liver-assist devices

Question 22 Explanation:

Glucocorticoid therapy, exchange transfusion, plasmapheresis, human cross-circulation, porcine liver cross-perfusion, hemoperfusion and extracorporeal liver-assist devices have not been proved to enhance survival. Meticulous intensive care that includes prophylactic antibiotic coverage is one factor that appears to improve survival. Orthotopic liver transplantation also has shown excellent results.

Question 23

Drugs that have been recommended in acute liver failure are all except ?

A	Lamivudine
B	Telbivudine
C	Adefovir
D	Entecavir

Question 23 Explanation:

Nucleoside/nucleotide analogues recommended in acute liver failure are lamivudine, telbivudine and entecavir. Adefovir has a slow action & potential nephrotoxicity. Interferon drugs are contraindicated because they can worsen hepatitis

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See all quizzes of Chronic hepatitis at here:

Chronic hepatitis- Part 1| Chronic hepatitis- Part 2| Chronic hepatitis- Part 3| Chronic hepatitis- Part 4

1.Interferon therapy results in activation of ?
A. Cytokines
B. Chemokines
C. JAKSTAT signal transduction pathway
D. All of the above

2. The current standard treatment of chronic hepatitis C is ?
A. PEG IFN
B. Ribavirin
C. PEG IFN + Ribavirin
D. All of the above

3. Which of the following variable does not correlate favourably
in the IFN-based treatment of chronic hepatitis C ?
A. Genotypes 2 and 3
B. Genotypes 1 and 4
C. Low baseline HCV RNA level
D. Histologically mild hepatitis

4. Duration of IFN-ribavirin therapy have in patients with genotype
1 should last for ?
A. 12 weeks
B. 24 weeks
C. 48 weeks
D. 72 weeks
5. Duration of IFN-ribavirin therapy have in patients with genotype
2 and 3 should last for ?
A. 12 weeks
B. 24 weeks
C. 48 weeks
D. 72 weeks

6.Which of the following is relevant for patients treated with PEG
IFN and ribavirin ?
A. SLCO1B1
B. HLA-B*1501
C. IL15
D. IL28B

7. The most pronounced side effect of ribavirin therapy is ?
A. Seizure
B. Agranulocytosis
C. Hemolysis
D. All of the above

8. Which of the following is a side effect of ribavirin therapy ?
A. Pruritus
B. Gout
C. Anemia
D. All of the above
9. Halflife in serum of Hepatitis C virion is ?
A. 2 – 3 hours
B. 2 – 3 days
C. 2 – 3 monhs
D. 2 – 3 years

10. Elimination time of PEG IFN is how many times longer than
standard IFN ?
A. Three times
B. Five times
C. Seven times
D. Nine times

11. Standard indication for antiviral therapy of chronic hepatitis C
is ?
A. Detectable HCV RNA (with or without elevated ALT)
B. Portal/bridging fibrosis on liver biopsy
C. Moderate to severe hepatitis on liver biopsy
D. All of the above
12. Antiviral therapy is not recommended in which of the following
patients of chronic hepatitis C ?

A. Age > 60 years
B. Mild hepatitis on liver biopsy
C. Persons with severe renal insufficiency
D. All of the above
13. Which of the following patients of chronic hepatitis C are not
candidates for IFN-based antiviral therapy ?
A. Decompensated cirrhosis
B. Pregnancy
C. Contraindications to use of interferon or ribavirin
D. All of the above

14. Duration of PEG IFN / ribavirin therapy in chronic hepatitis C
of genotypes 1 and 4 is ?
A. 12 weeks
B. 24 weeks
C. 48 weeks
D. 72 weeks
15. Duration of PEG IFN / ribavirin therapy in chronic hepatitis C
of genotypes 2 and 3 is ?
A. 12 weeks
B. 24 weeks
C. 48 weeks
D. 72 weeks
16. Dose of PEG IFN -2a is ?
A. 180 µg daily subcutaneously
B. 180 µg weekly subcutaneously
C. 180 µg daily intramuscularly
D. 180 µg weekly intramuscularly

17.Dose of PEG IFN -2b is ?
A. 0.5 µg / kg weekly subcutaneously
B. 1.5 µg / kg weekly subcutaneously
C. 2.5 µg / kg weekly subcutaneously
D. 3.5 µg / kg weekly subcutaneously

18. Which of the following is recommended for the success of
therapy with PEG IFN / ribavirin in chronic hepatitis C ?
A. HCV genotype should be determined prior to therapy
B. Measure HCV RNA at 12 weeks
C. Pretreatment liver biopsy
D. All of the above

19. Which of the following is advocated in those who have not
responded to treatment with PEG IFN / ribavirin in chronic
hepatitis C ?
A. Longer duration of treatment
B. Higher doses of either PEG IFN, ribavirin, or both
C. Switching to a different IFN preparation
D. All of the above

20. Which of the following associated with hepatitis C may respond
to antiviral therapy ?
A. Essential mixed cryoglobulinemia
B. Porphyria cutanea tarda
C. Lichen planus
D. All of the above
21. Which of the following drug is beneficial in acute hepatitis C ?
A. Lamivudine
B. Interferon monotherapy
C. Ribavirin
D. Glucocorticoid

22. In fulminant hepatitis, which of the following has been shown
to improve survival ?
A. Glucocorticoid therapy
B. Exchange transfusion
C. Prophylactic antibiotic coverage
D. Extracorporeal liver-assist devices

23. Drugs that have been recommended in acute liver failure are
all except ?
A. Lamivudine
B. Telbivudine
C. Adefovir
D. Entecavir

Chronic hepatitis

[MCQ] Chronic hepatitis- Part 4

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Chronic hepatitis- Part 3

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