GI Tract Infections, Viral Hepatitis/ Misc (Schoenwald) Flashcards
What is the source of the virus in Hepatitis A?
Feces
Is hepatitis A a chronic infection?
No
What is the route of transmission in Hepatitis A?
Fecal-oral
How can Hep A be prevented?
Pre/post exposure immunization
What is the source of the virus in Hep B?
Blood/blood-derived body fluids
What is the route of transmission for Hep B?
Percutaneous
Permucosal
Can Hep B be a chronic infection?
Yes
What is the prevention for Hep B?
Pre/post exposure immunization
What is the source of the virus in Hep C?
Blood/ blood-derived body fluids
What is the route of transmission in Hep C?
Percutaneous
Permucosal
Is Hep C a chronic infection?
Yes
How can Hep C be prevented?
Blood donor screening, risk behavior modification
What is the source of the virus in Hep D ?
Blood/blood-derived body fluids
What is the route of transmission in Hep D?
Percutaneous
Permucosal
Can Hep D be a chronic infection?
Yes
How can Hep D be prevented?
Pre/post exposure immunization, risk behavior modification
What is the source of Hep E?
Feces
What is the route of transmission in Hep E?
Fecal-oral
Does Hep E cause a chronic infection?
No
What can be done to prevent an infection with Hep E?
Ensure safe drinking water
What are the clinical symptoms in a acute hepatitis infection?
Nausea Vomiting Abdominal pain Loss of appetite Fever Diarrhea Light (clay colored) stool Dark urine Jaundice- yellowing of the eyes, skin
Can acute hepatitis be asymptomatic?
Yes
What are the possible body fluids that Hep A can be transmitted in?
Feces
Serum
Saliva
How is Hep A transmitted?
Close personal contact- household, sex, child care
Contaminated food, water, infected food handlers
Blood exposure (rare) IVDU, transfusion (rare)
The symptoms of an acute hepatitis infection can range from…
Asymptomatic
Symptomatic
Fulminant liver failure
Death
If symptoms are present in an acute hepatitis infection, they will be/ will not be the same regardless of what type of hepatitis infection
The symptoms will be the same regardless of what type of hepatitis infection the patient has
What is the most common type of body fluid that hepatitis A is spread in?
Feces
What patient populations should be assessed and vaccinated for Hepatitis A?
Drug users Homeless Men who have sex with men People who are currently incarcerated or were recently incarcerated People with chronic liver disease
–what do some of these populations have in common– they have less access to care/ choose not to seek care
What lab testing is available for hep a testing?
Hep A IgG
Hep A IgM
What does the Hep A IgG test evaluate?
Past infection or immunity- however, there is no way to delineate if the immunity is from the vaccine or from prior infection- this information should be obtained from the history
What does the Hep A IgM test evaluate?
Active infection
Hepatitis A is/ is not vaccine preventable
Is vaccine preventable
Havrix is the vaccination for Hep _
A
Havrix vaccination is approved for what age group?
12 months and older
What is the dosing regiment for Havrix in children and adolescents?
0.5ml dose, 2 shot series given 6 months apart
What is the dosing regiment for Havrix in adults?
1ml dose, 2 shot series given 6 months apart
What is Twinrix?
Hep A/B combination vaccine
What are the 2 FDA approved dosing schedules for Twinrix?
Standard (3 shot series given at day 0, 1 month, and 6 months)
Accelerated (4 shot series given at day 0, day 7, day 21, and 1 year)
What would be the benefit to giving the accelerated schedule for Twinrix?
Given to patients that will be putting themselves at risk for infection within the next few months (ex: travel)
What is the treatment for Hepatitis A?
Supportive- fluids, avoid Tylenol (extra stress on the liver), abstain from alcohol (detox?) , healthy diet. Patients can usually recover at home unless they have fulminate liver failure
Which virus is the most easily transmittable of all blood borne pathogens?
Hepatitis B
Hepatitis B is/ is not more prevalent than HIV
Is more prevalent
A hepatitis B infection may lead to…
Cirrhosis and/or cancer of the liver
What is the risk of a single needle stick in non immunized patients for Hep B?
6-30%
Hep B is/ is not vaccine preventable?
Preventable
How effective is the Hep B vaccine?
99.9% effective
What body fluids have a high concentration of Hep B?
Blood
Serum
Wound exudates
What body fluids have a moderate concentration of Hep B virus ?
Seminar
Vaginal fluid
Saliva
What body fluids have a low/ not detectable concentration of Hep B?
Urine Feces Sweat Tears Breast milk
How can Hep B be transmitted?
Sexual
Parenteral (needle? )
Perinatal (vertical transmission between mother and baby? )
HBV infection can be asymptomatic/ symptomatic
Both
HBV infection can be chronic or…
Resolved immune
What is HBsAg?
Hepatitis B surface antigen
Surface antigens of HBV detectable in large quantity in serum
If a person tests positive for HBsAg are they infectious?
Yes
What is Anti-HBs?
Antibody to Hep B surface antigen, indicates past infection with immunity to HBV, passive antibody from HBIG, or immune response from HB vaccine
What is HBIG?
Hepatitis B immunoglobulin is a human immunoglobulin that is used to prevent the development of hepatitis B and is used for the treatment of acute exposure to HBsAg
What is HBcAg?
Hep B core antigen- no commercial test available, used for research
What is anti-HBc?
Antibody to HBcAg- indicates a prior or recent infection with HBV
What is IgM anti-HBc?
IgM class antibody-indicates recent infection with HBV, detectable for 4-6 months after infection
What is HBeAg?
Hepatitis B e antigen, correlates with higher levels of HBV in serum and increased infectivity (higher possibility for infection)