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Clinical Management: Infectious Disease Flashcards

7 cards from real CSP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Clinical Management: Infectious Disease flashcards as text

  1. A treatment-naive patient with chronic HCV genotype 3 and no cirrhosis starts glecaprevir/pibrentasvir. What is the recommended treatment duration?

    Answer: 8 weeks

    Glecaprevir/pibrentasvir is given for 8 weeks to treatment-naive patients of any genotype, with or without compensated cirrhosis.

  2. A patient starting sofosbuvir/velpatasvir also takes amiodarone. What is the primary safety concern?

    Answer: Serious symptomatic bradycardia

    Giving sofosbuvir with amiodarone can cause serious, sometimes fatal, symptomatic bradycardia.

  3. Before starting direct-acting antiviral therapy for HCV, which screening is required because of a boxed warning?

    Answer: HBsAg and anti-HBc to assess hepatitis B reactivation risk

    HCV DAAs carry a boxed warning for HBV reactivation, so all patients need HBV screening first.

  4. A patient on sofosbuvir/velpatasvir needs a proton pump inhibitor. Why is this combination a concern?

    Answer: Higher gastric pH lowers velpatasvir solubility and absorption

    Velpatasvir solubility drops as pH rises, so if a PPI is needed, the DAA should be taken with food 4 hours before omeprazole 20 mg.

  5. Which HCV regimen is contraindicated in a patient with decompensated (Child-Pugh B or C) cirrhosis?

    Answer: Glecaprevir/pibrentasvir

    Regimens containing an NS3/4A protease inhibitor, such as glecaprevir, are contraindicated in decompensated cirrhosis because of hepatotoxicity risk.

  6. How is HCV cure (sustained virologic response) defined?

    Answer: Undetectable HCV RNA 12 weeks after the end of therapy

    SVR12, meaning undetectable HCV RNA 12 weeks after completing treatment, is considered a virologic cure.

  7. Which patient could shorten ledipasvir/sofosbuvir therapy to 8 weeks?

    Answer: Treatment-naive, genotype 1, non-cirrhotic, HCV RNA below 6 million IU/mL, HIV-negative

    The 8-week ledipasvir/sofosbuvir course is reserved for treatment-naive, non-cirrhotic, HIV-negative genotype 1 patients with baseline HCV RNA below 6 million IU/mL.