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GIN > hep tx > Flashcards

hep tx Flashcards

1
Q

surface antigen for Hep ___ and antibody for Hep ___

A

B

C

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2
Q

Risk factors of Hep C

A

Injection drug use*****

Baby boomer

multiple sexual partners

incarceration, occupational

long term hemodialysis

blood transfusion prior to 1992

clotting factor tx prior to 1987

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3
Q

Hep B therapy patient requirements

A

positive HBsAG

HBeAG(+/- will change tx)

ALT

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4
Q

FDA tx for Hep B

A

First line

  • PEG-IFN
  • Entecavir
  • Tenofovir

Second Line tx

  • IFN
  • Lamivudine
  • Adefovir
  • Telbivudine
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5
Q

Hep B, even in the absence of cirrhosis, can predispose to

A

HCC

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6
Q

What is the first test that becomes positive for Hep B?

A

surface antigen

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7
Q

window period is

A

loss of surface antigen before anti-HBs, some IgM-HBc (24-32 weeks)

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8
Q

Which serological markers are present in chronic infection of Hep B?

A

HBsAg and total antiHBc

not necessarily IgM anti-HBc

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9
Q

what is eAntigen?

A

mark of viral replication

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10
Q

Which marker is in actively infected Hep B patient versus someone who could be immunized?

A

HBsAg is the main marker for infectivity

HBsAb in both immunized and exposed

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11
Q

what is eAntigen?

A

mark of viral replication

assess treatment response

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12
Q

Which marker is in actively infected Hep B patient versus someone who could be immunized?

A

HBsAg is the main marker for infectivity

HBsAb in both immunized and exposed

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13
Q

Acute hep B marker and important for what other hepatitis?

A

Hep B Core Antibody IgM (HBc IgM) important for Hepatitis D infectiond

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14
Q

Hepatits Core Ab IgM + IgG total

A

someone exposed

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15
Q

Hep B surface Antibody no core Ab

A

immunized

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16
Q

Quantitative assay reports

A

viral load to assess treatment response

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17
Q

Inactive Chronic Hep B

A

HBsAg+> 6 months

no HBeAGg, HBeAb
HBV DNA <2,000

normal AST/ALT

liver biopsy without significant hepatitis

18
Q

Interferon

A

not well tolerated but great sAg loss

19
Q

Lamivudine

A

high risk of resistance, could be used for viral suppression during chemo

20
Q

Telbivudine

A

used in Asia

21
Q

Entecavir

A

common but low sAg loss.

22
Q

Sexual blood exposures should be avoided in

A

Hep B

23
Q

Check for HBsAg in all patients about to initiate

A

chemo

24
Q

Mother with Hep B pregnant, what should be done?

A

immunize the baby immediately and HBIg

25
Q

Tenofovir and Telbivudine can be used for

A

pregnant mothers in the 3rd trimester

26
Q

fulminant hep b serology

A

HBsAg+, HBc IgM+

27
Q

mot important screening for HCC for which hepatitis

A

Hepatitis B

28
Q

Hep C most prevalent

A

Egypt

29
Q

what percentage of Acute HCV turns to chronic infection and percentage to cirrhosis?

A

70-85% (Anti-HCV Ab+, HCV RNA +), 30% to cirrhosis

30
Q

HCV IgG Ab is not diagnostic, what is?

A

RNA by PCR

31
Q

common Hep genotypes in US

A

1a, 1b

32
Q

HCV IgG Ab is not diagnostic, what is used to confirm infected state?

A

RNA by PCR

33
Q

common Hep genotypes in US

A

1a, 1b

34
Q

What leads to a more rapid and progressive course of HCV

A

Alcohol

35
Q

what else should you test for in HCV infected person?

A

HIV (30% HIV+ concomitantly infected with HCV)

36
Q

extrahepatic Hep C manifestations?

A

Porphyria cutanea tarda

Leukocytoclastic vasculitis

Glomerulonephritis

Non-Hodgkin’s lymphoma

AutoI thyroiditis

DM

Sjogren’s

37
Q

Sustained Virological Response code word for

A

hep c is CURED

38
Q

PEG-IFN/RBV side affect

A

suicide

39
Q

What class of drugs are direct acting HCV therapies?

reference

A

NS3/4A protease inhibitors

NS5B Nucleotide Polymerase Inhibitor

NS5B Non-nucleotide Polymerase Inhibitor

NS5A Inhibitors

40
Q

Genotype 1 drug?

A

Harvoni (1)

Viekira Pak (1ab)

Zepatier

41
Q

Genotype 1-6 drug

A

Epclusa

GIN (11 decks)

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