GI - 5 Liver Disease pt 2

Question 1

Sensitive and precise marker of viral replication and infectivity
Small amounts can persist long after recovery.
Tells how much of the virus is in their blood

Answer 1

HBV DNA

Question 2

Hep _ only exists with Hep _

Answer 2

Hep D only exists with Hep B

Question 3

Progression from acute to chronic hepatitis B is primarily determined by:

Answer 3

the age at infection. Having Hep B since a child – highest chance of going on to have Chronic Hep B

Question 4

The persistence of which HBV antigen in the blood indicates carrier state?

Answer 4

HBsAg

Question 5

What does carrier state mean?

Answer 5

chronic disease

Question 6

in terms of hep B and D,
What does coinfect mean?
what does superinfect mean?
Which is worse?

Answer 6

Coinfect: D & B come together
Superinfect: already have B and then D - worse

Question 7

Treating Hep C depends on ___

Answer 7

the genotype

Question 8

Most are anicteric and asymptomatic with mild course

Jaundice:

Answer 8

Hep C

Question 9

How do you check if someone cleared Hep C?

Answer 9

check for Antibody for Hep C Virus: if they have it it means they should be tested for the viral load. If they don’t have viral load, then they cleared it.

Question 10

Having Anti HCV in blood ___ mean recovery

Answer 10

Having Anti HCV in blood: DOES NOT MEAN RECOVERY ****

Question 11

What is the treatment for Hep C/ Chronic Hep C? (2)

Answer 11

Interferon alpha

Peginterferon

Question 12

Treatment for Hep C is reserved for:

Answer 12

Often treatment is reserved for patients whose serum HCV RNA levels fail to clear after 3-4 mos

Question 13

If a patient is AntiHCV+ you can assume they are no longer infections
True
False

Answer 13

False. You have to do the viral load

Question 14

What Hep is this?
Self limited illness and NO CARRIER STATE*
High mortality rate in pregnant women(10-20%)*
Not in the USA

Answer 14

Hep E

Question 15

What 2 types of Hep have no carrier state?

Answer 15

Hep A and E have no carrier state (if you carry it you will show symptoms)

Question 16

Describe the 4 general phases of Hepatitis

Answer 16

1. Prodromal phase: Malaise, myalgias, arthralgias, fatigability , URI symptoms, anorexia
   Nausea, vomiting, diarrhea, or constipation (vague)
   +/- Serum sickness in acute HBV
   Fever is low grade if any (except HAV)
   RUQ or epigastric abdominal pain
2. Icteric phase: Jaundice occurs after 5-10 days if at all
   May occur with prodromal symptoms
3. Convalescent phase – getting better
4. Course & Complications: Hepatitis B, D, C, G may become chronic**
   A&E do not become chronic

Question 17

What general phase of Hepatitis is this?
Prodromal phase: Malaise, myalgias, arthralgias, fatigability , URI symptoms, anorexia
Nausea, vomiting, diarrhea, or constipation (vague)
+/- Serum sickness in acute HBV
Fever is low grade if any (except HAV)
RUQ or epigastric abdominal pain

Answer 17

1. Prodromal phase

Question 18

What general phase of Hepatitis is it when Jaundice may occur?

Answer 18

2. Icteric phase

Question 19

Which general phase of Hepatitis involves getting better, getting an appeitite back and such?

Answer 19

3. Convalescent phase

Question 20

What types of Hepatitis may become chronic? Which do not?

Answer 20

Hepatitis B, D, C, G may become chronic**

A&E do not become chronic

Question 21

4 signs of hepatitis

Answer 21

Hepatomegaly
Liver tenderness
Splenomegaly
Lymphadenopathy - Cervical and epitrochlear

Question 22

___ often precedes jaundice

Answer 22

Bilirubinuria

Question 23

A general lab finding for Hep is

Answer 23

High ALT/AST

Question 24

How do you prevent getting Hep A from someone who has it?

Answer 24

Immune globulin should be given to all close contacts and persons who consume food prepared by infected individual