Published in:
01-12-2009 | CME Post Test
CME post test
Published in: Hepatology International | Special Issue 1/2009
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1.
Suppression of HBV viral load in clinical trials is correlated with which type of favorable response?
a.
Histologic
b.
Serologic
c.
Biochemical
d.
All of the above
e.
None of the above
2.
True or False: Early viral suppression of HBV DNA levels is associated with improved response and a higher risk of resistance when using oral nucleos(t)ide analog NA antiviral therapy is used.
a.
True
b.
False
3.
True or False: Studies involving lamivudine treatment in patients with CHB seem to indicate that early virologic suppression correlates with sustained virologic response.
a.
True
b.
False
4.
Due to a potential single-site substitution (M204I) that may induce its resistance, which of the following therapies is (are) considered to have a low genetic barrier?
a.
Telbivudine
b.
Entecavir
c.
Lamivudine
d.
All of the above
e.
None of the above
5.
Adefovir dipivoxil:
a.
is an oral NA reverse transcriptase inhibitor with activity against HBV but not HIV
b.
is associated with durable viral suppression, consistent efficacy, and long-term safety in a broad range of patients with CHB
c.
appears to induce a lower rate of HBV DNA decrease when compared with than other oral antiviral agents
d.
All of the above
e.
None of the above
6.
True or False: Tenofovir, an acyclic NA with a molecular structure similar to that of adefovir, is approved for the treatment of patients with HIV infection and CHB.
a.
True
b.
False
7.
Which of the following was not a part of the “roadmap” algorithm discussed in this supplement?
a.
Quantitative HBV DNA monitoring at weeks 12 and 24
b.
Continued therapy with the same drug in patients with a complete virologic response, with repeat testing lengthened to 6-month intervals at the physician’s discretion
c.
Repeated monitoring at 3-month intervals in patients with a complete response who have been treated with a drug with a delayed antiviral effect and a relatively high barrier to resistance (e.g., adefovir)
8.
True or False: In the Asia–Pacific region, half of the CHB burden is the result of vertical mother-to-child transmission, with early childhood horizontal transmission accounting for the remaining half.
a.
True
b.
False
9.
In regard to CHB:
a.
CHB seldom causes specific symptoms
b.
serostatus can be established only by blood tests for HBsAg, while infectivity can be established by blood tests for HBV DNA
c.
the presence of disease can be established by regular monitoring with blood tests and liver imaging
d.
without therapeutic intervention, ≥30% of individuals with CHB will develop significant disease
e.
All of the above
f.
None of the above
10.
According to epidemiologic reviews, Asian patients generally undergo HBeAg seroconversion at a median age of:
a.
60 years
b.
21 years
c.
35 years
11.
Hormonal changes during pregnancy have no effect on the immune clearance of HBV.
a.
True
b.
False
12.
Which of the following is (are) not a barrier (barriers) to improvement in HBV programs?
a.
The relative expense of recombinant HBV vaccines
b.
The small number of efficient and dedicated healthcare systems to deliver the important first dose of the hepatitis B vaccine to infants within 24 hours of birth
c.
Lack of knowledge among mothers
d.
Lack of commitment from healthcare providers
e.
All of the above are barriers
13.
A number of possibilities account for poor response to HBV vaccination, including:
a.
intrauterine infection
b.
vaccine escape mutants
c.
host genetic hyporesponsiveness or nonresponsiveness to HBsAg
d.
immune compromise
e.
All of the above
14.
Initial methods for the quantification of HBeAg and HBsAg include:
a.
radioimmunoassay
b.
fluorescence
c.
chemiluminescence
d.
electro-immunodiffusion
e.
All of the above
f.
None of the above
15.
In regard to HBeAg:
a.
it appears only during CHB infection
b.
its detection is indicative of immunity
c.
Both a and b
d.
Neither a nor b
16.
True or False: Mutations in the precore and basal core promoter regions of HBV arise under host immune pressure and may prevent the translation of HBeAg or reduced expression of HBeAg.
a.
True
b.
False
17.
Current society guidelines define the ULN values for serum ALT as __ IU/ml for men and __ IU/ml for women:
a.
30, 19
b.
30, 30
c.
19, 30
d.
19, 19
18.
Pretreatment predictors of increased response to PegIFN alfa therapy in patients with HBeAg-positive CHB include:
a.
high pretreatment ALT (>2 × ULN)
b.
low viral load
c.
increased histologic activity
d.
young age
e.
female gender
f.
genotypes A and B
g.
All of the above
19.
Factors associated with a more durable HBeAg seroconversion following lamivudine therapy include:
a.
longer duration of consolidation treatment
b.
younger age
c.
lower end of treatment viral load
d.
genotype B compared with genotype C
e.
All of the above
20.
Which of the following factors is (are) predictive of HBeAg loss in patients treated with lamivudine monotherapy?
a.
Elevated baseline ALT
b.
Elevated histologic activity index score
c.
Both a and b
d.
Neither a nor b
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