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✅ Interpretation of Viral Testing in Dialysis Patients – MCQs (Set 1)
1. Which viral markers are routinely screened in dialysis patients?
A. HBsAg, Anti-HCV, Anti-HAV
B. HBsAg, Anti-HCV, HIV Ag/Ab
C. HBeAg, Anti-HBc, CMV IgG
D. Anti-HAV, Anti-HBs, EBV IgM
➡️ Answer: B. HBsAg, Anti-HCV, HIV Ag/Ab
2. A dialysis patient tests positive for HBsAg. What does this indicate?
A. Past hepatitis B infection
B. Immunity to HBV
C. Current HBV infection (carrier or active)
D. Recent HBV vaccination
➡️ Answer: C. Current HBV infection (carrier or active)
3. Which result indicates immunity due to vaccination against hepatitis B?
A. HBsAg positive
B. Anti-HBc IgG positive
C. Anti-HBs positive (>10 mIU/mL)
D. Anti-HCV positive
➡️ Answer: C. Anti-HBs positive (>10 mIU/mL)
4. A dialysis patient has Anti-HCV positive and HCV RNA undetectable. Interpretation?
A. Acute HCV infection
B. No exposure to HCV
C. Past HCV infection, resolved
D. Early infection not yet viremic
➡️ Answer: C. Past HCV infection, resolved
5. Which of the following markers is most definitive for detecting active Hepatitis C infection?
A. ALT/AST levels
B. Anti-HCV
C. HCV RNA PCR
D. HCV genotype
➡️ Answer: C. HCV RNA PCR
6. In dialysis, a patient with positive Anti-HBs and negative HBsAg & Anti-HBc likely indicates:
A. Recent infection
B. Immunity from past infection
C. Vaccine-induced immunity
D. Immunosuppression
➡️ Answer: C. Vaccine-induced immunity
7. When should HBsAg be tested in dialysis patients per CDC recommendations?
A. Every 2 weeks
B. Every month
C. Every 6 months
D. Monthly for new patients, then every 6 months if negative
➡️ Answer: D. Monthly for new patients, then every 6 months if negative
8. What should be done if a dialysis patient is newly diagnosed with active HBV (HBsAg+)?
A. No change in schedule
B. Isolate machine, cohort in HBV room
C. Repeat test in 1 month
D. Discontinue dialysis
➡️ Answer: B. Isolate machine, cohort in HBV room
9. HIV Ag/Ab combo tests in dialysis patients detect:
A. HIV antibodies only
B. HIV RNA
C. Both HIV p24 antigen and antibodies
D. HIV DNA
➡️ Answer: C. Both HIV p24 antigen and antibodies
10. Anti-HBc (core antibody) positive and HBsAg negative indicates:
A. Acute infection
B. Vaccinated only
C. Resolved HBV infection
D. No exposure
➡️ Answer: C. Resolved HBV infection
11. A dialysis patient is HBsAg negative but Anti-HBc positive and Anti-HBs negative. What is the most likely interpretation?
A. Immunity from vaccination
B. Window period of infection
C. Resolved HBV infection
D. False-positive Anti-HBc
➡️ Answer: B. Window period of infection (possible but needs HBV DNA testing to confirm)
12. A patient is Anti-HCV positive but has persistently normal ALT and AST. What should be done next?
A. Start treatment immediately
B. No action needed
C. Confirm with HCV RNA PCR
D. Test for HBsAg
➡️ Answer: C. Confirm with HCV RNA PCR
13. Which of the following hepatitis B markers would be expected to appear first in acute infection?
A. Anti-HBs
B. HBsAg
C. Anti-HBc IgG
D. HBeAg
➡️ Answer: B. HBsAg
14. In the dialysis unit, which of the following is a criterion to classify a patient as HBV immune?
A. HBsAg positive
B. Anti-HBs <10 mIU/mL
C. Anti-HBs ≥10 mIU/mL
D. HBeAg negative
➡️ Answer: C. Anti-HBs ≥10 mIU/mL
15. What is the CDC-recommended interval for HCV testing in dialysis patients?
A. Every 3 months
B. Every 6 months
C. Annually
D. Every 2 years
➡️ Answer: C. Annually
16. A dialysis staff member is accidentally exposed to a patient's blood. The patient is Anti-HCV positive. What is the next step?
A. Start antiviral treatment
B. Test the staff for HCV RNA
C. Wait for symptoms
D. Immediate HIV testing
➡️ Answer: B. Test the staff for HCV RNA (and baseline serology)
17. Which test confirms chronic HBV infection?
A. Anti-HBs ≥10 mIU/mL
B. HBsAg positive for more than 6 months
C. Anti-HBc IgM
D. ALT within normal limits
➡️ Answer: B. HBsAg positive for more than 6 months
18. Which hepatitis virus has the highest risk of transmission in the dialysis setting?
A. HAV
B. HCV
C. HBV
D. HEV
➡️ Answer: C. HBV
(due to higher viral load and environmental stability)
19. What is the appropriate action for a dialysis patient with reactive HIV antigen/antibody combo test?
A. Immediate isolation
B. Confirm with HIV-1 RNA or Western blot
C. Repeat the same test
D. Inform the patient directly without confirmation
➡️ Answer: B. Confirm with HIV-1 RNA or Western blot
20. The presence of Anti-HBc IgM in a dialysis patient suggests:
A. Past infection
B. Chronic infection
C. Acute or recent HBV infection
D. Vaccination-induced immunity
➡️ Answer: C. Acute or recent HBV infection
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