Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Hepatobiliary and pancreatic disorders > Goljan Viral hepatitis > Flashcards

Goljan Viral hepatitis Flashcards

1
Q

Phases of acute viral hep

A

prodrome;
jaundice;
recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is associated w/ prodrome in acute viral hep?

A

fever;
painful hepatomegaly (distaste for alcohol/cigs);
serum transaminases increase gradually=> peak BEFORE jaundice;
atypical lymphocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Wht is associated w/ jaundice from acute viral hep?

A

variable finding that depends on type of hepatitis=> increased urine bilirubin and urine UBG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Micro findings of acute viral hep

A

lymphocytic infiltrate w/ destruction of hepatocytes;

persistent inflammation and fibrosis (not good sign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does persistent inflammation and fibrosis in viral hep mean?

A

chronic hep progressing to postnecrotic cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When are Councilman bodies found?

A

apoptosis of hepatocytes from acute viral hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List in order of commonality of the viral causing hepatitis diseases

A

A > B > C > D > E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is HAV transmitted?

A

fecal oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Epidemiology of HAV

A

infectious;
incubation 15-50days;
most preventable infection in travelers;
day care centers; prisons; travelers; anal intercourse; parents adopting from other countries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clinical findings of HAV

A

jaundice >70%;
fever;
N/V;
abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

lasting effects of HAV?

A

majority recover, no carrier state;

NO chronic hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Serology of HAV

A

anti-HAV-IgM => active infection

anti-HAV-IgG=> recovery from infection or vaccination (protective)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How is passive immunization for HAV accomplished?

A

Ig for pre-exposure prophylaxis and postexposure prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is active immunization for HAV accomplished?

A

protective Abs in 1mo from infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

transmission of HBV

A

parenteral;
oral;
sexual;
vertical (pregnancy, breast feeding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is primary spread of HBV? How long is incubation period?

A

blood and sexually;

incubation is 30-180days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how does HBV infection present clinically?

A 
variable fever; profound malaise; 
painful hepatomegaly (87%); 
serum sickness prodrome (15-20%);
immunocomplex disease (HBsAg + Ab);
vasculitis (PAN);
urticaria, polyarthritis, membranous glomerulopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Recovery potential in HBV?

A

> 90% of immunocompromised pts;

1-2% develop chronic hep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Who is most likely to develop chronic hep?

A

newborns and immunodeficient pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Complications of HBV infection

A

fulminant hepatitis <1% esp if coinfected w/ HDV;

hepatocellular carcinoma secondary to postnecrotic cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When does HBsAg appear? how long does it persist?

A

appears w/in 2-8wks after exposure (1st mark);

persists up to 4mo in acute hepatitis (last to leave)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what defines chronic HBV?

A

HBsAg longer than 6mo;

anti-HBc-IgM converts to anti-HBc-IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the infective particles of HBV?

A

HBeAg and HBV-DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the nonprotective Ab of HBV infection? when is it present?

A

anti-HBc-IgM;
positive in acute infection;
present while HBsAg, HBV-DNA, HBeAg being absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What does anti-HBc-IgM convert to by 6mo?

A

converts entirely to anti-HBc-IgG by 6mo

26
Q

What is anti-HBs indicate?

A

protective Ab;

marker of immunization after HBV vaccination

27
Q

What indicates a “healthy” chronic carrier?

A

HBsAg and anti-HBc-IgG;

absence of DNA and e antigen;

28
Q

Is a patient w/ HBsAg and anti-HBc-IgG and absence of DNA and e antigen contagious?

A

yes but much lower risk

29
Q

What is present in a infective chronic carrier?

A

HBsAg, anti-HBs-IgG;

infective particles DNA and e antigen

30
Q

What is the risk for a infective chronic carrier of HBV?

A

increased risk for postnecrotic cirrhosis and hepatocellular carcinoma

31
Q

How is HBV prevented?

A

immunization w/ recombinant vaccine

32
Q

What is the Tx for chronic hepatitis?

A

pegylated IFN-a;
nucleoside analogues that block viral replication (lamivudine, entecavir);
liver transplant

33
Q

what Ab is present during the serologic gap?

A

anti-HBc-IgM

34
Q

How is HCV transmitted? what is the incubation period for HCV?

A

transmitted parenteral or sexual => MC blood borne infection in US;
incubation 2-26wks

35
Q

What are infrequent ways of transmission of HCV?

A

post-transfusion hepatitis;

maternal-fetal transmission

36
Q

Why is HCV such a difficult disease in US?

A

most common main indication for liver transplant

37
Q

clinical findings w/ HCV

A 
chronic hepatitis (>70% cases)
mild hepatitis (70-80% subclinical);
jaundice uncommon (80% anicteric)
38
Q

Clinical assoc w/ HCV

A 
type I MPGN, 
alcohol excess, 
PCT, 
lichen planus, 
B cell lymphoma
39
Q

complications assoc w/ HCV

A

hepatocellular CA secondary to postnecrotic cirrhosis

40
Q

prevention of HCV

A

NONE

41
Q

Tx for HCV

A

early Tx of acute infection w/ pegylated IFN-a may prevent chronic infection;
pegylated IFN-a used in chronic HCV;
liver transplant

42
Q

transmission for HDV

A

parenteral or sexual

43
Q

pathogenesis for HDV infection

A

incomplete RNA virus that requires HBsAg to replicate

44
Q

describe the chronic state of HDV infection

A

less likely w/ coinfection (HBV, HDV exposure at same time) than superinfection (HBV carrier exposed to blood containing HBV and HDV)

45
Q

How often does chronic infection w/ HDV occur?

A

60-85% of ppl infected get chronic infection

46
Q

prevention of HDV?

A

immunization w/ recombinant vaccine for HBV

47
Q

transmission of HEV?

A

fecal-oral => water borne

48
Q

Where is HEV most likely to be found? what does it lead to?

A

developing countries;

only produces acute hepatitis

49
Q

who is at risk for fulminant hep from HEV?

A

pregnant women

50
Q

How can HCV be screened?

A

enzyme immunoassay => EIA;
presence of anti-HCV-IgG indicates active infection or recovery => 97% sensitive
does not differentiate bw types of infection or provide protection

51
Q

What are confirmatory tests for HCV?

A

recombinant immunoblot assay (RIBA)=> use if EIA is positive

HCV RNA using PCR;

52
Q

What is the gold standard for Dx HCV? when does it detect?

A

HCV RNA using PCR => detects 1-2 wks after infection

53
Q

What tests will confirm active HCV infection?

A

positive RIBA and HCV RNA

54
Q

What tests will indicate recent recovery?

A

positive RIBA and negative HCV RNA

55
Q

What indicates active HDV infection?

A

anti-HDV-IgM or IgG

56
Q

Ab protection for HDV?

A

no => anti-HDV-IgG is NOT protective

57
Q

what indicates active HEV infection?

A

anti-HEV-IgM

58
Q

what indicates recovery from HEV infection? any Ab protection?

A

anti-HEV-IgG indicates recovery and provides a protective Ab

59
Q

What is associated w/ CB20-50% in mixed hyperbilirubinemia?

A

decreased uptake/conjugation of UCB;

CB gains access to blood via damaged bile ductules

60
Q

What would cause urine UBG elevation and increased urine bilirubin

A

CB is water soluble and filtered in kidneys;

UBG recycled back to inflamed liver is redirected to kidneys

61
Q

What is the last liver enzyme to return to normal?

A

ALT

Hepatobiliary and pancreatic disorders (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions