Post-exposure protection against hepatitis A can be given as
Answer: A
Healthy contacts are usually offered vaccine, while immune globulin is preferred for infants, older adults and the immunocompromised, and either must be given within two weeks. No antiviral drug is used for hepatitis A.
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Hepatitis A was formerly known as
Answer: B
The older names described the routes: infectious hepatitis spread from person to person, while serum hepatitis followed injections and transfusions and is what we now call hepatitis B. The letters replaced them once the viruses were identified.
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Before the viruses were identified, the form following injections and transfusions was called
Answer: C
Correct answer: serum hepatitis
Before the agents were identified the two syndromes were distinguished by how they spread: infectious hepatitis, spread person to person and now known as A, and serum hepatitis, following injections and transfusions and now known as B. The old names survive in the literature and describe the epidemiology accurately.
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The hepatitis B surface antigen was originally called the
Answer: D
It was first found in the serum of an Australian Aboriginal donor, and the name persisted until its nature was understood. The complete virion is still sometimes called the Dane particle after the worker who described it.
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Which hepatitis virus is most often associated with contaminated shellfish?
Answer: A
Filter-feeding shellfish concentrate virus from sewage-contaminated water, and eating them raw or lightly cooked has caused many outbreaks. It follows directly from the faecal-oral route and the hardiness of the naked virion.
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An infected food handler is a recognised source of outbreaks of
Answer: B
Correct answer: hepatitis A
An infected food handler sheds virus in the stool for a week or two before becoming jaundiced, and by then may have prepared food for hundreds of people. Since hepatitis A is enterically transmitted and survives well on surfaces, this is a classic outbreak scenario. The blood-borne viruses are not spread this way.
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Safe drinking water and good sanitation prevent chiefly
Answer: C
Both are enterically transmitted, so breaking the faecal-oral route by treating water and disposing of sewage properly prevents them. The blood-borne viruses are unaffected by sanitation and need quite different measures.
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Not sharing needles and syringes prevents chiefly
Answer: D
Correct answer: hepatitis B and C
Both are blood-borne, and sharing injecting equipment transfers enough blood to transmit either - hepatitis B being the more infectious by that route and hepatitis C the more common among people who inject. A and E are enteric and unaffected by needle sharing.
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Vertical transmission of hepatitis B means transmission
Answer: A
Correct answer: from mother to infant around the time of birth
Vertical transmission occurs chiefly at delivery, through contact with maternal blood and secretions, rather than across the placenta. That timing is what makes intervention possible: vaccine and immune globulin given to the infant within hours of birth prevent most infections.
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Which hepatitis virus requires another virus in order to spread?
Answer: B
Correct answer: Hepatitis D
The delta agent carries its own genome and antigen but no envelope gene, so it can be packaged and released only in a cell also making hepatitis B surface antigen. It therefore occurs only as a coinfection with B or as a superinfection of a chronic carrier, the latter carrying the worse prognosis.
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