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Gastroenterology > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

transmitted via oral-fecal

A

acute hepatitis A

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2
Q

when does acute hepatitis A present in feces before clinical illness?

A

2 weeks before

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3
Q

what is the major risk factor of acute hepatitis A?

A

international travel

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4
Q

a patient presents with fever, fatigue, anorexia, N/V/D, RUQ pain, muscle and joint pain, jaundice, distaste for smoking and +/- white (acholic) stools. Dx?

A

acute hepatitis A

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5
Q

in a patient with acute hepatitis A, what coincides (occurs) with improvement of fever?

A

jaundice

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6
Q

what will be seen in labs in a patient with acute hepatitis A? (4)

A

large atypical lymphocytes
markedly elevated AST/ALT
elevated total bilirubin
elevated alk phos

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7
Q

what will be seen in labs before jaundice in acute Hep A? (2)

A

mild proteinuria
bilirubinuria

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8
Q

a patient’s labs show + anti-HAV IgM, +/- anti-HAV IgG, and + HAV. Dx?

A

acute HAV infection

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9
Q

a patient’s labs show - anti-HAV IgM, + anti-HAV IgG, and - HAV. Dx?

A

prior HAV vaccine or infection

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10
Q

a patient’s labs show - anti-HAV IgM, - anti-HAV IgG, and - HAV. Dx?

A

not infected or vaccinated

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11
Q

what is the treatment for acute hepatitis A? (2)

A

supportive tx
no hepatotoxins

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12
Q

what is the treatment for acute hepatitis A with encephalopathy or coagulopathy? (2)

A

hospitalization
liver transplant

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13
Q

when do most patients clinically recover from acute hepatitis A?

A

within 3 months

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14
Q

a patient between 1-40 yo who has been exposed to HAV should have which prophylaxis vaccine?

A

HAV vaccine

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15
Q

a patient younger than 1 and older than 40 yo who has been exposed to HAV should have which prophylaxis vaccine?

A

HAV immune globulin + vaccine

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16
Q

transmitted by infected blood, blood products, sexual contact, and can be transmitted from mothers to infant during delivery

A

acute hepatitis B

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17
Q

a patient presents with fever, fatigue, anorexia, nausea, RUQ pain, jaundice, and hepatomegaly on palpation and percussion. Dx?

A

acute hepatitis B

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18
Q

what lab is associated with increased mortality in acute hepatitis B?

A

prolonged PT

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19
Q

found on outer shell of virus, an early sign of infection; can indicate acute or chronic HBV infection

A

HBsAG (surface antigens)

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20
Q

antibody to outer shell of virus, shows immunity from vaccine or previous exposure to Hep B virus

21
Q

antibody to protein found inside virus; indicates active infection or previous exposure, not from vaccine

22
Q

indicates the Hep B virus is actively replicating

23
Q

antibody to envelope antigen; differentiates early from diminishing or sub-acute infection

24
Q

a patient presents with + HBsAg. Dx?

A

early acute HBV infection

25
Q

a patient presents with + anti-HBc IgM and + HBsAg. Dx?

A

acute HBV infection

26
Q

a patient presents with + anti-HBc IgG and + anti-HBs. Dx?

A

resolved acute HBV infection

27
Q

a patient presents with + anti-HBc IgG and + HBsAg. Dx?

A

chronic HBV infection

28
Q

a patient presents with + anti-HBs. Dx?

A

prior vaccination, no infection

29
Q

a patient presents with - anti-HBc IgM, anti-HBc IgG, HBsAg, and anti-HBs. Dx?

A

no infection or prior vaccination

30
Q

what is the treatment for acute hep B?

A

supportive tx

31
Q

what is the management for acute hep B with encephalopathy or coagulopathy?

A

hospitalization

32
Q

what is the treatment for severe acute hep B with elevated INR and jaundice > 4 weeks, and acute liver failure?

A

tenofovir / entecavir
D/C meds after HBsAg is negative in 2 tests, 4 weeks apart

33
Q

what indicates a transition from acute hep B to chronic hepatitis?

A

elevated liver enzymes for > 6 months

34
Q

what is the prophylaxis in an unvaccinated patient post-exposure to HBV?

A

hep B immune globulin + Hep B vaccine series

35
Q

transmitted via infected blood and blood products.

A

acute hepatitis C

36
Q

what does acute HCV develop into in most patients?

A

chronic HCV

37
Q

what is the most common risk factor for acute hepatitis C?

A

IV drug use

38
Q

a patient presents without symptoms, but can present with +/- viral syndrome, jaundice, and abdominal pain. Dx?

A

acute hepatitis C

39
Q

what is the first line diagnostic test for acute hepatitis C?

A

enzyme immunoassay (EIA) for HCV antibodies

40
Q

what other test can be done to confirm acute hepatitis C if EIA is positive?

A

HCV RNA PCR

41
Q

what is the CDC diagnostic criteria for acute hep C infection?

A

ALT over 7x the upper limit of normal

42
Q

what is the treatment for acute hep C?

A

antiviral meds based on genotype testing

43
Q

what only causes hepatitis in association with acute or chronic HBV?

A

hepatitis D

44
Q

what does hepatitis D increase the risk of?

A

hepatocellular carcinoma

45
Q

inflammation of the liver with elevated AST/ALT over > 6 months.

A

chronic hepatitis B

46
Q

what is treatment for chronic hep B based on? (3)

A

presence of cirrhosis
ALT
HBV levels

47
Q

what is important to note in labs of a patient with chronic hep C?

A

AST/ALT normal in 40% of cases

48
Q

what diagnostic are used for chronic hep C? (2)

A

anti-HCV by ELISA for screening
HCV RNA by PCR for confirmation

49
Q

what is the treatment for chronic hep C?

A

antiviral depending on genotype testing

Gastroenterology (26 decks)

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