USMLE STEP 3 MCQ 20 : A health aid worker sustains an accidental needlestick injury

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Question:


A health aid worker sustains an accidental needlestick injury contaminated by blood from a Hepatitis B positive person. He has been appropriately vaccinated against Hepatitis B. He is given a Hepatitis B vaccine booster. What other agent is most likely to help reduce the severity of clinical infection with hepatitis B?

a) hepatitis B immune globulin (HBIG
b) hepatitis B virus DNA
c) hepatitis B e antigen
d) hepatitis A
e) a course of acyclovir


Correct Answer: C

Explanation:


Hepatitis B immune globulin (HBIG) is prepared from the plasma of persons with high-titer anti-HBs and contains anti-HBs at titers in the range of 1:100,000 or higher. HBIG appears to attenuate clinical illness, rather than prevent infection. It is recommended in conjunction with the vaccine for postexposure prophylaxis. Hepatitis B vaccine (already given in this patient) has been recommended as preexposure prophylaxis, primarily for population subgroups considered to be at high risk of exposure to HBV (eg, health and laboratory workers exposed to blood, hemodialysis staff and patients, residents and staff of custodial institutions, promiscuous persons, IV drug users, patients requiring repeated administration of blood products or clotting factors, and household and sexual contacts of chronic HBsAg carriers).


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