MCQS 244-246:A blood transfusion center in a third world country are keen to reduce the incidence of posttransfusion hepatitis C in their blood products

The insertion of cannulated screws is the treatment of choice for:
a) osteoarthrosis of the hip
b) congenital dislocation of the hip
c) slipped femoral epiphysis
d) Perthe’s Disease
e) septic arthritis
f) Subtrochanteric fracture
g) Posterior Hip Dislocation
h) Anterior Hip Dislocation
i) femoral neck fracture
j) intertrochanteric fracture
A 70 year old woman with congestive heart failure is being managed well with a loop diuretic. The patients potassium levels have been low. Which agent used in combination with a loop diuretic to prevent potassium depletion?
a) hydrochlorothiazide
b) captopril
c) A loop diuretic
d) warfarin
e) calcium supplements
f) vitamin K
g) verapamil
h) beta blockers
i) digitalis
j) amiloride

A blood transfusion center in a third world country are keen to reduce the incidence of posttransfusion hepatitis C in their blood products. Which measure is most likely to reduce the incidence of posttransfusion hepatitis C in this center?
a) recombinant hepatitis B vaccine
b) hepatitis C virus
c) Hepatitis B surface antigen
d) hepatitis C vaccine
e) hepatitis D
f) hepatitis B immune globulin (HBIG)
g) hepatitis B virus DNA
h) hepatitis B e antigen
i) hepatitis A
j) atopic dermatitis

Correct Answer: I
With an intracapsular (femoral neck) fracture, displacement can be absent, minimal, or marked. Patients with undisplaced and minimally displaced fractures experience very little loss of blood at the site because of the tamponade provided by the intact capsule. Because there is little disruption of the blood supply to the femoral head, and because good bony contact is maintained between the fracture surfaces, these patients require only a relatively small operation to insert cannulated screws. Very little blood is lost during this type of operation, and the patient is permitted to put weight on the hip immediately after recovery from anesthesia.

Correct Answer: J
The potassium-sparing diuretics (amiloride, triamterene) are relatively weak agents used mainly in conjunction with thiazides and loop diuretics to prevent potassium depletion. Their onset of action is slow; full effect may take up to a week to become evident.

Correct Answer: J
The incidence of posttransfusion hepatitis C has been dramatically reduced by excluding commercially donated blood and persons at high risk of transmitting bloodborne disease as well as by screening prospective donors for evidence of HCV infection (eg, presence of anti-HCV, elevated aminotransferase). Immune globulin and HBIG are of no proven benefit in preventing transfusion-associated hepatitis C. However, some authorities recommend a single IG injection for needlestick, sexual, or perinatal exposure to hepatitis C, although efficacy has never been demonstrated and the anti-HCV in IG is not neutralizing. There is no vaccine for hepatitis C, and the acquisition of neutralizing antibody after naturally acquired hepatitis C is considered rare. Still, efforts to develop a protective vaccine based on immunization with envelope proteins is being pursued


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