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Question 1

HBV PEP?

Answer 1

Known sAg positive-

• Known responder to vaccine- give booster
• non responder or mid vax course- give HBIG and vax

Not known status

• known responder- booster
• non responder- HBIG and vaccine
• mid vac: accelerate the course, no HBIG

Question 2

HIVPEP?

Answer 2

within 1-2 hours, max 72 hours start course multiple drugs for 4 weeks
serology at 12 weeks
reduce risk 80%

Question 3

HCV PEP?

Answer 3

check HCV RNA monthly with PCR

If go positive then give IFN and ribavirin

Question 4

Needlestick highest risk?

Answer 4

Hep B 20-30%

Question 5

Syphilis- which test stays positive?

Answer 5

treponema pallidum haemagluttinin test TPHA

remember that VDRL and RPR are insensitive in late disease

false positive non treponemal with preg, SLE (they are cardiolipins), TB, leprosy, malaria, HIV

Question 6

Explain EBV serology

Answer 6

VCA IgG- up at onset of illness
VCA IgM- up at onset of illness and wanes at 3 months

EBNA- up for life from 6-12 weeks