General pathology

Question 1

What causes Lynch syndrome?

Answer 1

Lynch syndrome  Autosomal dominant  Inherited mutation in MMR gene  Acquired second mutation in MMR gene

Question 2

What are protective levels of immunity for Hep B?

Answer 2

 <10 iu/ml – no evidence of immunity
o Consider repeat course
 10-100 iu/ml – low levels of immunity
o Give booster
 >100 iu/ml – full immunity
o No action

Question 3

What are the risks of transmission if the source patient is:

a) HIV antibody positive?
b) Hepatitis C antibody positive?
c) Hepatitis B surface antigen positive?
d) Hepatitis B e antigen positive?

Answer 3

1. HIV antibody positive - 1 in 300 (0.3%)
2. Hepatitis C antibody positive - 1 in 30 (3%)
3. Hepatitis B surface antigen positive - 1 in 30 (3%)
4. Hepatitis B e antigen positive – 1 in 3 (30%)

Question 4

How should HIV exposure be treated?

Answer 4

o Taking medications within 72 hours at the latest
 Three active drugs - 2 nucleoside analogues plus an integrase inhibitor for 28 days
 Current guidelines:
o Recommended combination
 Truvada (a combination tablet of tenofovir disoproxil fumarate and emtricitabine)
 plus
 Raltegravir