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Q4 Clin Med III (GI) > Exam 2 HEPATITIS > Flashcards

Exam 2 HEPATITIS Flashcards

1
Q

Hep A transmission?

Chronic?

A

Fecal/Oral

No

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2
Q

Hep A risk factors? (3)

A

Travel (50%)
Close contact
MSM

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3
Q

Hep A presentation?

A

Acute
Kids asympt
Prodrome: flu sxs, RUQ pain
Icteric Phase: jaundice, dark urine, pruritis, light stool

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4
Q

Hep A labs? (3)

A

LFT = ↑AST/ALT, ↑bilirubin
+ IgM Ab = acute infection
+ IgG Ab = immunity (past infection)

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5
Q

Hep A tx? (2)

Post-exposure?

Admit when? (3)

A

Supportive

Ig or vaccine for close contacts

Post-exposure:
Pts 12mo - 40yo and healthy, vaccine w/i 2wks
Otherwise IG

Hospitalize if:
Old
Co-morbidities
Underlying liver dz

REPORTABLE

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6
Q

Hep B type of virus?

Transmission?

Leading cause of what?

A

DNA

Blood/Body fluid

Cirrhosis and Hepatocellular CA

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7
Q

Hep B risk factors? (5)

A 
Close contact
MSM/Multiple partners
IV drug users
Infants from mother
Health workers

95% of infected adults clear virus w/o getting dz

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8
Q

Acute Hep B presentation? (3)

Labs? (1)

A

Flu sxs
RUQ pain
Jaundice

LFT = ↑AST/ALT

Rarely hepatic failure

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9
Q

Chronic Hep B presentation? (4)

A

C asympt
Anorexia/Wgt loss
Fatigue
Heaptomegaly

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10
Q

Chronic Hep B labs? (2)

A

LFT = mild ↑AST/ALT

Hep B surface antigen = + > 6mo

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11
Q

Chronic Hep B complications? (2)

A

Cirrhosis

Hepatocellular CA

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12
Q

Hep B surface antigen (HBsAg) is?

A 
HALLMARK OF ACTIVE INFECTION
1st marker
↑ before sx onset
Detectible ~4wks post exposure
Detectible > 6 mo = chronic infection
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13
Q

Antibody to hep B surface antigen (anti-HBs) tells us?

A

Signifies recovery and IMMUNITY

Hep B vaccine = + anti-HBs

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14
Q

Antibody to hep B core antigen (anti-HBc) tells us:

IgM anti-HBc?

IgG anti-HBc?

A

IgM anti-HBc:
Detectible shortly after HBsAg
Indicates acute or recent infection
Persists ~6 mo

IgG anti-HBc:
Indicates prior or resolving infection
Persists forever

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15
Q

Hep B envelope antigen (HBeAg) tells us?

A

Infective state (virus replicating)

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16
Q

Antibody to hep B envelope antigen (anti-HBe) tells us?

A

Lower levels of virus

17
Q

Hep B Immunity from infection vs vaccine:

Hep B surface antibody (anti-HBs)?

Hep B core antibody IgG (anti-HBc IgG)?

A

Anti-HBs:
Infection = +
Vaccine = +

Anti-HBc IgG:
Infection = +
Vaccine = -

18
Q

Hep B post-exposure prophylaxis?

A

IG protects

and ↓ severity if given w/i 7 days of exposure

19
Q

Acute Hep B tx?

Admit when? (4)

A

Supportive
P anitviral
r/o Hep D co-inf

Admit if:
Underlying liver dz
Co-morbids
Old
Signs of failure

REPORTABLE

20
Q

Chronic Hep B tx:

Goal?

Which pts?

F/U?

A 
Goal:
Stop replication (-HbeAg, +anti-HBe)

Pts w/ active replication:
+HBeAg, +Hep B DNA, ↑AST/ALT

Monitor for cirro and H CA
Vaccine

21
Q

Hep C type of virus?

Transmission?

Most C of what?

A

RNA

Blood/Body fluid

Chronic bloodborne infection
(80% become chronic)
Liver transplant

22
Q

Hep C Rule of 20s?

A

20% infected will clear virus
20% w/ chronic will get cirrhosis w/i 20 yrs
20% of them will get H CA

23
Q

Hep C risk factors? (5)

A 
IV drug use
Blood trans/Clotting factors
HIV
Infants from mom
Close contact less likely
24
Q

Acute Hep C presentation? (4)

A

Most are asympt
Flu sxs
RUQ pain
Jaundice

25
Q

Chronic Hep C presentation?

A

Most asympt

Diagnosed from ↑ LFT w/ varying patterns

26
Q

Hep C diagnostics?

A 
Antibody to hep C (anti-HCV) = past or ongoing infection
If + order HCV RNA to:
1) confirm active virus
2) determine viral load
3) Determine genotype
27
Q

Hep C management? (6)

A 
Liver bx for staging dz
NO EtOH
No new meds w/o careful review
Screen and vacc for Hep A/B 
Screen HIV
Monitor for cirro and H CA
28
Q

Hep C pt precautions? (3)

A

Can’t donate blood/organs
Don’t share personal items
Cover open wounds

29
Q

Hep C Rx tx?

Cured when?

A

Interferon + Ribavirin
6-12 mo
+ protease inhib if geno 1

Cure = no detectible virus > 6 mo

30
Q

Hep D type of virus?

Seen when?

A

Delta RNA

Only as co-inf w/ Hep B

31
Q

Hep D diagnositcs?

A

Delta RNA with +HBsAg

*test all Hep B pts for Hep D

32
Q

Hep D tx?

A

Treat Hep B

33
Q

Hep E type of virus?

Transmission?

A

E RNA

Fecal/Oral
U from travel

34
Q

Hep E diagnostics?

Prognosis?

Tx?

A

Hep E RNA

Fatal in 20% of preggos,
Otherwise <1%

Supportive

Q4 Clin Med III (GI) (32 decks)

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