EXAM #2: LIVER PATHOLOGY II Flashcards
Which Hepatitis viruses are transmitted via the fecal-oral route?
1) HAV
2) HEV
How is HAV commonly acquired?
Traveling
How is HEV commonly acquired?
1) Contaminated water
2) Undercooked seafood
What is the clinical manifestation of HAV or HEV infection?
Acute hepatitis; no chronic state
What marks active infection with HAV or HEV?
anti-HAV or HEV IgM
What marks prior exposure (or immunization) to HAV/ HEV?
anti-HAV or HEV IgM
In a patient with anti-HAV IgG antibodies, what are the possible interpretations?
1) Prior infection
2) Immunization
In what patient population can HEV infection lead to fulminant hepatitis?
Pregnant women
How is HBV transmitted?
Parenterally
- Childbirth
- Unprotected intercourse
- ID drug abuse (IVDA)
What is the clinical manifestation of HBV infection?
Acute hepatitis (only 20% chronic)
How is HCV transmitted?
Parenterally
- IVDA
- Unprotected sex
What is the clinical manifestation of HCV infection?
BOTH acute and chronic hepatitis
How is HCV infection diagnosed?
HCV-RNA
In evaluating a patient with HCV, what do declining HCV-RNA level indicate? What is levels remain the same?
Recovery vs. persistence/ chronic infection
How does then HBV virus differ from the other hepatitis viruses?
- dsDNA virus vs. ssRNA
- Hepadnavirus vs. picorna virus
What is HDV infection dependent on? Why?
HDV infection requires infection with HBV
- Requires HBsAg to infect (Hepatitis B Surface Antigen)
What is HDV coinfection?
HBV + HDV infect at the same time
What is HDV superinfection?
Pre-existing HBV infection THEN HDV infection
Which is worse, coinfection of superinfection with HDV?
Superinfection–chronic hepatitis and cirrhosis are common complications
What are the extrahepatic manifestations of Hepatitis B? How do these differ in adults and children?
Children= glomerulonephritis
Adults= polyarteritis nodosa
*Antigen/antibody complexes are deposits in the nephrons or medium sized vessels.
What are the extrahepatic manifestations of Hepatitis C?
1) Cryoglobulinemia (cold temperature induced agglutination of RBCs)
2) Thyroiditis
3) Glomerulonephritis
4) Thrombocytopenia
Which genotype of HCV is associated with more severe inflammation?
HCV-2
Note that HCV-1 in the US is associated with resistance to treatment
What happens with HCV and Alcoholism?
Accelerated progression to cirrhosis
What factors predispose HCV infection to HCC?
- Cirrhosis
- Age
- Male sex
- Alcohol