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Prevention of Hepatitis B Infection in the US

Introduction

1. HBV is highly infectious and can be transmitted in the absence of visible blood.

A. True

B. False


2. HBV remains viable on environmental surfaces for at least _____ days.

A. 3

B. 7

C. 10

D. 14


New or Updated Recommendations

3. A universal hepatitis B vaccination is recommended within 24 hours of birth for medically stable infants weighing greater than or equal to 3,000 grams.

A. True

B. False


HBV Background

4. The 2015 incidence is greatest for persons aged:

A. Less than 19 year

B. 20 to 29 years

C. 30 to 39 years

D. 40 to 49 years


5. Foreign-born persons account for approximately 95% of newly reported chronic infections in the United States.

A. True

B. False


6. The majority of chronic HBV infections in the United States are among:

A. Blacks / African Americans

B. Whites / Caucasians

C. Latinos / Hispanics

D. Asians / Pacific Islanders


7. Where is the primary site of HBV replication?

A. Liver

B. Spleen

C. Kidneys

D. Blood


8. Which of the following is the most infectious?

A. Those with elevated HBV RNA

B. Those with hepatitis B e antigen

C. Those with occult HBV

D. All HBsAg-positive persons are equally infectious


9. HBsAg found in breast milk is likely to lead to transmission and hence HBV infection is a contraindication to breastfeeding.

A. True

B. False


10. Transmission of HBV from transfusion of blood or blood products is rare because of donor screening and viral inactivation procedures.

A. True

B. False


11. Newly acquired HBV infection is typically asymptomatic in which of the following?

A. Older children

B. Adolescents

C. Adults

D. Immunosuppressed adults


12. Which phase of chronic HBV infection is characterized by an active immune response resulting in hepatic inflammation, with or without fibrosis?

A. Immune tolerant

B. Immune active

C. Immune inactive

D. Reactivation


13. The majority of cases of perinatal HBV transmission occur in utero.

A. True

B. False


14. Transient HBsAg positivity can occur up to 18 days following vaccination and is clinically insignificant.

A. True

B. False


15. Which of the following is indicative of past infection?

A. IgG anti-Hbc

B. IgM anti-Hbc

C. IgE anti-Hbc

D. IgA anti-Hbc


16. The Occupational Safety and Health Administration mandates that employers offer HepB vaccination to all employees who have occupational risk and that postexposure prophylaxis is available following an exposure.

A. True

B. False


17. Compared with adults without, adults with _____ have a 60% higher prevalence of past or present HBV infection and twice the odds of acquiring acute HBV.

A. HIV / AIDS

B. Cardiovascular disease

C. Diabetes

D. Cancer


Prophylaxis Against HBV Infection

18. Aluminum salts generally are used as adjuvants to enhance the immune response of vaccinated persons.

A. True

B. False


19. All of the following factors contribute to a decreased response to vaccine, except for:

A. Smoking

B. Aging

C. Genetic factors

D. Female sex


20. A study among low birth weight infants demonstrated that more infants achieved seroprotective anti-HBs levels when vaccine was initiated within the first 3 days of life versus at 1 month of age.

A. True

B. False


Recommendations

21. Which type of vaccine should be used for the birth dose for infants born to women who are HBsAg-positive?

A. Single-antigen HepB vaccine only.

B. Combination HepB vaccine only.

C. Both single-antigen HepB and combination HepB vaccines should be administered together.

D. Either single-antigen HepB or combination HepB vaccines can be administered, but they should not be administered together.


22. Postvaccination serologic testing for anti-HBs and HBsAg should not be performed before age _____ months to avoid detection of passive anti-HBs from HBIG administered at birth and to maximize the likelihood of detecting late HBV infection.

A. 3

B. 6

C. 9

D. 12


23. HBsAg-negative infants with anti-HBs levels greater than or equal to 10 mIU/mL are protected and need no further medical management.

A. True

B. False


24. The final dose in the series should not be administered before _____ weeks when managing infants born to women with unknown HBsAg status.

A. 12

B. 16

C. 20

D. 24


25. All infants should receive the HepB vaccine series as part of the recommended childhood immunization schedule beginning at birth as a safety net.

A. True

B. False


26. Acknowledgement of which specific risk factor should be a requirement for vaccination of all unvaccinated adults at risk for HBV infection?

A. Men who have sex with men.

B. Current or recent injection-drug users.

C. Persons with hepatitis C virus infection.

D. Acknowledgement of a specific risk factor should not be a requirement for vaccination.


27. Using antiseptics for wound care and expressing fluid by squeezing the wound further have been shown to reduce the risk for HBV transmission.

A. True

B. False


28. Health care personnel with anti-HBs greater than 10 mIU/mL after receipt of the primary series should be revaccinated.

A. True

B. False


29. Health care personnel who cannot provide documentation for _____ of HepB vaccine should be considered unvaccinated and should complete the vaccine series.

A. A minimum of 1 dose

B. At least 2 doses

C. All 3 doses

D. Documentation isn’t required if their anti-HBs is greater than 10 mIU/mL


30. All HepB vaccine doses must be produced by the same manufacturer to be considered valid.

A. True

B. False


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