Block 4 - Viral hepatitis Flashcards

1
Q

Hepatitis A-E

Feces is a source for which one?

A

A + E

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2
Q

Hepatitis A-E

Blood, bodily fluids are a source for which one?

A

B, C, and D

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3
Q

Hepatitis A-E

Which one presents with a chronic infection?

A

B, C, and D

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4
Q

Hepatitis A-E

Which one is preventable via immunization?

A

A, B and D

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5
Q

Hepatitis A-E

Which one is prevented by safe drinking water?

A

E

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6
Q

Hepatitis A-E

Which one is prevented by behavior modification or through blood donor screening?

A

C

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7
Q

What kind of virus is Hep. A?

A

RNA virus of Picornaviridae family

Self-limiting, usually acute

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8
Q

How do you treat Hep A?

A

You dont

Provide supportive care, most fully recover within 6 months

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9
Q

IM injection + Hep A

A

HAVRIX and VAQTA are almost the same

Age 1-18 dose = 0.5ml
Age ≥19 dose = 1ml

Schedule month 0 and 6-12 (18 for VAQTA)

TWINRIX, which covers Hep A and B, it has 3 doses at month 0,1,6

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10
Q

What kind of virus is Hep B?

A

DNA virus, partially double stranded

Highly virulent, 50-100x more infectious than HIV

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11
Q

What are the Hep B vaccines?

A

Engerix, Recombivax, and Heplisav-B

TWINRIX for Hep A + B

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12
Q

Engerix
Recombivax
Heplisav-B

Which one is for all ages?

A

Engerix

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13
Q

Engerix
Recombivax
Heplisav-B

Which one has 3 doses?

A

Engerix + Recombivax (months 0, 1, 6)

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14
Q

Engerix
Recombivax
Heplisav-B

Which one is approved for ages ≥1 yo?

A

Recombivax

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15
Q

Engerix
Recombivax
Heplisav-B

Which one is approved for ages ≥18yo?

A

Heplisav-B

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16
Q

Engerix
Recombivax
Heplisav-B

Which one has 2 doses?

A

Heplisav-B (months 0, 1)

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17
Q

Anyone which active HBV is defined as…

A

HBV DNA >2000

ALT≥2x ULN or evidence of advanced fibrosis

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18
Q

What is the first line Tx for chronic HBV?

A

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

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19
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one is contraindicated if CrCl <15?

A

Tenofovir Ala.

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20
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one inhibits HBV replication using 3 steps?

A

Entecavir

Primes polymerase, reverse transcriptase, and then DNA synthesis

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21
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one has AE of nephropathy?

A

Tenofovir DF

22
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one has AE of lactic acidosis?

A

Entecavir

23
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one is given SQ?

A

Pegylated IFN

24
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one must monitor CBC, TSH, and any psychiatric disorders?

A

Pegylated IFN

25
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one has a dose increase if lamivudine experienced or has decompensated cirrhosis?

A

Entecavir (from 0.5 to 1 tablet)

26
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one has to be taken with food?

A

Tenofovir Ala.

27
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one is treated in a finite amount of time?

A

Pegylated IFN (48 wks)

28
Q

HBV with HCV co-infection, what should you know?

A

Screen for HCV

Reactivation of HBV can occur while on HCV tx

29
Q

HBV with HDV co-infection, what should you know?

A

Must have HBV infection

Pegylated interferon is DOC

30
Q

HBV with HIV co-infection, what should you know?

A

Tx should include one of the tenofovirs + another drug

31
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one is approved for children ≥1yo?

A

Pegylated IFN

32
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one is approved for children ≥2 yo?

A

Entecavir

33
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one is approved for children ≥12 yo

A

Tenofovir DF

34
Q

If HBV DNA in mother is >_______then ____ is recommended to be used in the ____ trimester

A

If HBV DNA is > 200,000 IU/mL, then TDF is recommended in the 3rd trimester

35
Q

When should infants receive hep B immunoglobulin when they are born?

A

Within 12 hrs

36
Q

Pegylated IFN
Entecavir
Tenofovir DF
Tenofovir Ala..

Which one is safe to use while pregnant?

A

Tenofovir DF

Pegylated IFN is used BEFORE pregnancy

37
Q

What type of virus is Hep C?

A

Single stranded RNA virus

38
Q

What are the Tx options for Hep. C?

A

NS3/4A “previrs”
NS5B “buvirs”
NS5A “asvir”

Always choose ≥2 agents from different classes

39
Q

Which Rx cover all genotypes of Hep. C?

A

S/V
G/P
S/V/V

40
Q

Which Hep C regimen should avoid w/ rosuvastatin?

A

S/L

Amiodarone too

41
Q

All Hep C regimens should avoid with what?

A

anticonvulsants, rifamycins, St. Johns Wort

42
Q

Which Hep C regimen should avoid w/ cyclosporine?

A

G/E

43
Q

Which Hep. C regimen requests RAS testing?

A

G/E

Also elevates AST/ALT

44
Q

Which Hep C regimen should avoid PPIs, amiodarone?

A

S/V

45
Q

Which Hep C regimen requires 3 tablets every day with food?

A

G/P

S/V/V requires just food tho

46
Q

Which Hep C regimen should be avoided with >100mg cyclosporine, ethinyl estradiol, atorvastatin, lovastatin, and simvastatin

A

G/P

47
Q

HCV 1a, Tx regimen and duration?

A

S/V 12wks

G/P 8wks

G/E 12wks

S/L 8 or 12wks (8 if no HIV and <6mil units)

48
Q

HCV 1b, Tx regimen and duration?

A

Same as 1a

49
Q

HCV 2 or 3, Tx regimen and duration?

A

S/V 12 wks

G/P 8 wks

50
Q

HCV 4, Tx regimen and duration?

A

Same as 1a

51
Q

Post treatment of HCV, when should you check the viral load?

A

In 12 weeks