GI infections and hepatitis

Question 1

what are the most common species that cause campylobacter?

Answer 1

C.jejuni

C.coli

Question 2

what is the main mode of transmission for campylobacter?

Answer 2

contaminated raw or undercooked poultry

Question 3

where is the site of damage from campylorbacter?

Answer 3

Terminal ileum and colon

Question 4

what are symptoms of campylobacter?

Answer 4

Varies from loose stool to severe inflammatory diarrhoea

-malaise, cramp, pain, fever

Question 5

how long does campylobacter infection last?

Answer 5

majority 1 week

Question 6

what is the main way of diagnosing campylobacter?

Answer 6

Culture

Question 7

how is c.diff diagnosed?

Answer 7

ELISA to detect toxins

Question 8

what is the treatment for c.diff?

Answer 8

early deetection; piptazobactam

oral metronidazole

Question 9

what are risk factors for C.diff infection?

Answer 9

Antibiotic use
hospitalisation and length
Age

Question 10

what antibiotics are the worse for giving C.diff a competitive advantage?

Answer 10

2nd and 3rd gen cephalosporins
quinolones
clindamycin

Question 11

what internal damage does C.dif cause?

Answer 11

• patchy necrosis with neutrophil inflammation
• epithelial ulcers
• pseudomembranes

Question 12

what is the best antibiotic for treating C.diff?

Answer 12

fidaxomicin

Question 13

what three antibiotics can be given for mild to moderate C.diff?

Answer 13

Fidaxomicin
Metronidazole
Vancomycin

Question 14

what can be given for severe C.diff?

Answer 14

Vancomycin

IV metronidazole

Question 15

what can be done for recurrent C/diff infections?

Answer 15

Fidaxomicin
Pulsed reducing antibiotics
faecal transplant

Question 16

what is the two phase test for C.diff?

Answer 16

1. glutamate dehydrogenase which is found in all C.diff

2. Toxin ELISA for A and B that cause the infection

Question 17

how can you detect C.diff toxin?

Answer 17

• two phase test
• PCR
• toxigenic culture

Question 18

what structure is norovirus?

Answer 18

A small non enveloped calicivirus RNA

Question 19

why is it a problem that norovirus is non enveloped?

Answer 19

Isn’t killed by alcohol gel

Question 20

what norovirus genogroups are found in humans?

Answer 20

1,2,4

Question 21

what is the clinical presentation of norovirus?

Answer 21

• acute onset
• vomiting and non inflammatory diarrhoea
• self limiting
• abdo cramps

Question 22

what is the incubation period for norovirus?

Answer 22

48 hours

Question 23

how does norovirus cause illness?

Answer 23

It infects the villi of the small intestine

it disrupts the absorptive function

Question 24

why is it hard to get norovirus immunity?

Answer 24

• wide antigenic variability
• limited cross protection
• immunity is temporary

Question 25

how is norovirus caught?

Answer 25

Faecal oral route. directly including droplet spread contaminated food and water

Question 26

how do you diagnose norovirus?

Answer 26

- PCR | norovirus can not be cultured

Question 27

what is the treatment for norovirus?

Answer 27

supportive only

Question 28

what is the most common cause of hepatocellular carcinoma?

Answer 28

Hepatitis B

Question 29

what type of virus is hep B?

Answer 29

DNA

Question 30

how is hep B transmitted?

Answer 30

Blood sexual intercourse Vertical transmission

Question 31

why does hep B cause liver damage?

Answer 31

No directly but due to both the humoral and cell immune response

Question 32

what is the incubation period for acute hep B?

Answer 32

1-4 months

Question 33

what are the signs of acute hep B?

Answer 33

Flu like symptoms RUQ pain jaundice

Question 34

what are the lab findings in acute Hep B?

Answer 34

increased ALT and AST

Question 35

what can the outcomes be of acute hep B?

Answer 35

- clearance of the infection (majority) - progression to liver failure - chronic hepatitis

Question 36

how does acute hep B lead to chronic hepatitis in some people?

Answer 36

Due to a suboptimal immune response where the virus can't be cleared

Question 37

what is hepBsAg?

Answer 37

Hepatitis B antigen Checks for ACTIVE infection ACUTE OR CHRONIC

Question 38

what is HepBsAb?

Answer 38

Hepatitis B antibody | checks for immunity especially through vaccination

Question 39

what is HepBCore Ab total?

Answer 39

checks for immunity due to previous infection

Question 40

what is HepBCOre IGM?

Answer 40

checks for recent acute infection

Question 41

what is HepBeAg?

Answer 41

checks for high infectivity

Question 42

what is HepBeAb?

Answer 42

Checks for low infectivity

Question 43

what serology will come up if there is an acute hepaptic B infection?

Answer 43

Positive HepBsAg | Negative HepBsAb

Question 44

what pre-exposure hep B prevention is there?

Answer 44

Immunisation with the recombinant vaccination

Question 45

what is the serology timeline for hep infection?

Answer 45

HBsAg rises 4 weeks after exposure until 24 weeks Total Anti-HbC rises 6 weeks after and stays risen IgM rises 6 weeks until 32

Question 46

what Is HBsAg?

Answer 46

hepatitis B surface antigen present during any (acute or chronic) hepatitis infection. Also indicates they are infectious

Question 47

what is anti- HBs?

Answer 47

hepatitis B surface antibody indicates recovery and immunity from infection and in people successfully vaccinated

Question 48

what is anti- HBc?

Answer 48

total hepatitis B core antibody | appears at the onset of symptoms in acute and remains for life

Question 49

what is IgM anti HBc?

Answer 49

IgM antibody to hepatitis B core antigen. positive indicates recent infection in the last 6 months.

Question 50

when will anti- HBs be positive?

Answer 50

Resolved infection | immunity due to vaccination

Question 51

when will anti HBc IgM be positive?

Answer 51

``` acute infection resolving infection (6 month life span) ```

Question 52

when will anti HbC be positive?

Answer 52

``` Acute infection resolving infection resolved infection high infective carrier low infective carrier ``` (after acute infection it's positive for life)

Question 53

what is the difference between HepBeAg and HepBeAb?

Answer 53

Ab- low infectivity | Ag- high infectivity.

Question 54

what type of virus is Hep A?

Answer 54

RNA

Question 55

how is hep A transmitted?

Answer 55

faecal oral route

Question 56

when is hep A most infectious?

Answer 56

Before any symptoms develop

Question 57

what is the incubation period of hep A?

Answer 57

15-50 days

Question 58

what is the difference between hep A and B?

Answer 58

Hep B can become chronic hep A can't Hep B can be blood spread hep A is not

Question 59

how is Hep A prevented?

Answer 59

- an infected person should remain off work for 7 days

Question 60

what type of virus is Hep C?

Answer 60

RNA with many genotypes

Question 61

how is hep C spread?

Answer 61

person to person by blood or percutaneous vertical transmission dialysis

Question 62

what is the incubation period of HepC?

Answer 62

14-180 days

Question 63

what are the signs of hep C?

Answer 63

most people are asymptomatic

Question 64

what markers show chronic Hep C infection?

Answer 64

HCV RNA | HCV p22 core antigen

Question 65

Who can get hepatitis D?

Answer 65

Only people with hepatitis B

Question 66

what does hepatitis D need to replicate?

Answer 66

Hepatitis B

Question 67

what is the incubation period of hep D?

Answer 67

3-7 weeks

Question 68

what type of virus is hepatitis E?

Answer 68

Single stranded RNA

Question 69

how is hep E spreaded?

Answer 69

Faecal Oral | can be waterbourne outbreaks

Question 70

what is the incubation period of hep E?

Answer 70

15-64 days

Question 71

what is different about the levels of IgG and IgM in hep E?

Answer 71

IgM peaks early then becomes undetectable | IgG continues to increase long term