Hepatitis

Question 1

signs of hepatitis

Answer 1

jaundice in whites of eyes or skin
enlarged liver and spleen
asterixis and coma (in fulminant hepatitis with hepatic encephalopathy)
extrahepatic symptoms in rare cases

Question 2

symptoms of hepatitis

Answer 2

most are asymptomatic
flu-like symptoms
fever
fatigue/malaise
anorexia
N/V/D
dark urine
pale-appearing stools
pruritis
abdominal pain

Question 3

Hep A virus prevention

Answer 3

good personal hygiene and proper disposal of sanitary waste
frequent handwashing after using restroom/prior to eating
Hep A vaccine or IGIM if at high risk

Question 4

HAV vaccine ADRs

Answer 4

injection site reaction
headache within 5 days
fatigue
children may have sleep disturbances

Question 5

when should a second dose of HAV vaccine be given?

Answer 5

6 months after the first

covers 100% prophylaxis

Question 6

most common ADRs of HBIG

Answer 6

erythema at injection site
headaches
myalgia
fatigue
uticaria
N/V

Question 7

vaccination schedule for HBV

Answer 7

first injection
second injection at 1 month
third at 6 months

Question 8

advantage of pegylated INF

Answer 8

once weekly dosing!!

Question 9

advantages of INF therapy

Answer 9

finite duration of treatment
lack of resistance
possible HBsAg loss or seroconversion

Question 10

INF ADRs and disadvantages

Answer 10

ADRs - fatigue, headache, insomnia, irritability, depression, suicidal ideation, allopecia, dermatitis
need for subcutaneous injections

Question 11

INF BBWs

Answer 11

neuropsychiatric adverse events

autoimmune, ischemic, or infectious disorders

Question 12

lamivudine ADRs

Answer 12

fatigue
N/V/D
headaches

Question 13

lamivudine BBWs

Answer 13

lactic acidosis
hep B exacerbations after discontinuation
HIV resistance may emerge

Question 14

adefovir ADRs

Answer 14

asthenia
abdominal pain
diarrhea
dyspepsia
headaches
nausea
flatulence

Question 15

adefovir BBWs

Answer 15

lactic acidosis
Hep B exacerbations with discontinuation
HIV resistance
dose-related nephrotoxicity

Question 16

entecavir ADRs

Answer 16

fatigue
N/V/D
headaches
abdominal pain
dyspepsia
flatulence
adjust for renal dysfunction

Question 17

entecavir BBWs

Answer 17

lactic acidosis
Hep B exacerbations with discontinuation
HIV resistance

Question 18

treatment of choice for HCV

Answer 18

pegylated interferon alpha-2a and 2b

Question 19

ribavirin ADRs

Answer 19

fatigue
headache
insomnia
nausea
anemia

Question 20

ribavirin BBWs

Answer 20

hemolytic anemia
not monotherapy!!!
pregnancy cat X
use caution in ventilation patients

Question 21

treatment combination for HCV

Answer 21

pegylated INF
ribavirin
boceprevir or telaprevir
all for 48 weeks

Question 22

boceprevir ADRs

Answer 22

fatigue, chills, insomnia, irritability, dizziness, headache, alopecia, dry skin, rash, N/V/D, abnormal taste, anorexia, dry mouth, anemia, neutropenia, weakness, dyspnea, thrombocytopenia

Question 23

telaprevir ADRs

Answer 23

fatigue, rash, pruritis, hyperuricemia, N/V/D, hemorrhoids, anorectal discomfort, anemia, lymphopenia, hyperbilirubinemia, abnormal taste, anal pruritis, thrombocytopenia