Instructions: Print this exam worksheet. Return to the course page using the link below. Read the course material. Enter your answers on this worksheet. Return to the course page and click the link 'Take Test.' Transfer your answers.

https://www.quantumunitsed.com/go/637

Quantum Units Education

Hepatitis C in Prison Populations

Screening for HCV Infection

1. Testing for HCV infection is recommended for:

A. All sentenced inmates.

B. All inmates with certain medical conditions.

C. All inmates who request testing.

D. All of the above.


2. The incarcerated population is reported to have higher prevalence rates of HCV than the general population and is identified by the AASLD and USPSTF as a risk factor for which screening is recommended.

A. True

B. False


3. All of the following are well-described risk factors, which should be considered when recommending HCV testing to sentenced inmates, except for:

A. HIV or chronic hepatitis A virus infection.

B. Ever received hemodialysis.

C. Born to a mother who had HCV infection at the time of delivery.

D. Born between 1945 and 1965.


Initial Evaluation of Anti-HCV Positive Inmates

4. Undetectable levels of HCV RNA indicate:

A. Resolved infection

B. A false positive HCV Ab test

C. Either (A) or (B)

D. None of the above


5. In the evaluation of a positive HCV Ab test, testing for other causes of liver disease (e.g., antinuclear antibody, ferritin, iron saturation, and ceruloplasmin) should be routinely ordered.

A. True

B. False


6. If a person is known to have cirrhosis, the AST to Platelet Ratio Index is irrelevant and unnecessary.

A. True

B. False


Assess For Hepatic Cirrhosis And Decompensation

7. All of the following are signs and symptoms that support the diagnosis of cirrhosis, except for:

A. High albumin

B. Low platelets

C. Esophageal varices

D. Ascites


8. Which of the following is the BOP-preferred method for non-invasive assessment of hepatic fibrosis and cirrhosis?

A. The APRI score

B. Abdominal imaging studies

C. Signs and symptoms

D. All of the above


9. Which of the following is true with regard to the APRI score?

A. At a cutoff of greater than or equal to 2.0, the APRI score has a sensitivity of 94%, but a specificity of 48% for predicting cirrhosis.

B. Inmates with an APRI score of greater than or equal to 2.0 should have an abdominal ultrasound performed to identify other findings consistent with cirrhosis.

C. An APRI score is necessary for diagnosing cirrhosis even if cirrhosis has been diagnosed by other means.

D. All of the above are true.


10. The APRI score may be invalidated in cases of:

A. Splenectomy

B. Cholecystectomy

C. Nephrectomy

D. All of the above


11. Abdominal imaging studies such as ultrasound or CT scan may identify findings consistent with or suggestive of:

A. Cirrhosis

B. Portal hypertension

C. Hepatocellular carcinoma

D. All of the above


12. The CTP score is a useful tool to help determine the severity of cirrhosis and is used by the AASLD to distinguish between compensated and decompensated liver disease in patients with known or suspected cirrhosis.

A. True

B. False


13. The pneumococcal vaccine should be offered to all HCV-infected inmates with cirrhosis regardless of their age.

A. True

B. False


14. In general, NSAIDs should be avoided in advanced liver disease / cirrhosis, and metformin should be avoided in decompensated cirrhosis.

A. True

B. False


BOP Priority Criteria for HCV Treatment

15. Which of the following is a high priority for treatment?

A. Evidence for progressive fibrosis.

B. Comorbid medical conditions associated with HCV.

C. Comorbid medical conditions associated with more rapid progression of fibrosis.

D. All of the above.


Recommended Treatment Regimens

16. Direct acting antiviral medications cannot be used as monotherapy, but instead must be used in combination with at least one other DAA or with ribavirin, and in some cases with peginterferon.

A. True

B. False


17. Which of the following is an approved treatment for all six HCV genotypes?

A. Daclatasvir + Sofosbuvir

B. Elbasvir / Grazoprevir

C. Sofosbuvir / Velpatasvir

D. Ledipasvir / Sofosbuvir


18. HCV protease inhibitors for genotypes 1 and 4 are not recommended.

A. True

B. False


Monitoring

19. Prior to starting treatment for HCV infection, patient education for which of the following is recommended?

A. How to take the medication.

B. The importance of adherence, monitory, and follow-up.

C. Potential medication side effects.

D. All of the above.


20. A test for thyroid stimulating hormone is recommended every 12 weeks only for patients receiving regimens containing:

A. Ribavirin

B. Paritaprevir

C. Interferon

D. All of the above


Special Considerations

21. Ledipasvir / sofosbuvir may be used with all antiretrovirals.

A. True

B. False


22. Which of the following DAAs is approved for use with GFRs less than 30 and with hemodialysis?

A. Daclatasvir + Sofosbuvir

B. Elbasvir / Grazoprevir

C. Sofosbuvir / Velpatasvir

D. Ledipasvir / Sofosbuvir


Copyright © 2017 Quantum Units Education

Visit us at QuantumUnitsEd.com!