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Infectious Diseases > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

Hepatitis is a general term meaning what

A

Infection of the liver

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2
Q

What distinct disease causes yellow discoloration of the skin due to bile accumulated in the liver

A

Jaundice

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3
Q

This was termed _____ since hepatitis was so common among military men

A

Campaign Jaundice

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4
Q

What are the two types of Hepatitis

A

Acute self-limited and Persistent chronic

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5
Q

Which forms of Hepatitis are classified as Acute self-limited

A

A and E

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6
Q

Which forms of Hepatitis are classified as Persistent Chronic

A

B, C, D, F, and G

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7
Q

Approximately ____ of hepatitis infections remain unexplained

A

15-17%

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8
Q

What is the Australian antigen

A

IN 1963, they were doing blood screening to detect blood proteins unique to geographical areas using hemophiliac’s serum. The used the blood from an Australian aborigine had a protein that reacted specifically with the serum antibody of an American hemophiliac. Thus receiving its name, since presence of antigen correlated with serum hepatitis

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9
Q

What is the hepatitis B virion’s alternative name

A

The Dane Particle

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10
Q

What is the etiological agent of Hepatitis

A

hepadnavirus

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11
Q

Describe the etiological agent of Hepatitis

A

Spherical, enveloped, icosahedral nucleocapsid, circular double stranded DNA with single strand gap on one strand. Encodes for 7 proteins

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12
Q

What are the distinctive characteristics of the hepadnavirus

A

usually partly double stranded and partly single stranded, reverse transcriptase generates genome DNA for pregenome RNA within capsid during virus assembly, makes large amt of noninfectious spherical filamentous particles

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13
Q

Double shelled capsid is unique to which form of hepatitis

A

Hepatitis B

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14
Q

Which antigen is the reverse transcriptase

A

The P antigen

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15
Q

What are the unique antigens that are used for diagnostic of Hepatitis B

A

HBsAg, HBcAg, and HBeAg

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16
Q

What is HBsAg

A

it is the surface antigen also known as the Australian antigen

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17
Q

What is the HBcAg

A

the core antigen

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18
Q

What is HBeAg

A

Endogenous DNA polymerase. It correlates with virus replication

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19
Q

What are the other animals know to have been infected with Hepatitis

A

woodchucks, ground squirrels, and ducks

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20
Q

Which of hepatitis’ hosts are known to develop carrier states (ACS)

A

Humans, Chimps, Woodchucks, and ducks

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21
Q

Which of hepatitis’ hosts are known to develop hepatocellular carcinoma (HCC)

A

Humans, Chimps and Woodchucks

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22
Q

Can the hepadnavirus be cultivated in vitro

A

No

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23
Q

How many people today worldwide are estimated to be infected with Hepatitis B

A

2 billion

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24
Q

About ___ persons have chronic infection (carrier)

A

400 million

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25
Q

An estimated ___ persons die each year due to acute or chronic consequences of hepatitis B and approx. ____ people die each min.

A

1 million; 2

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26
Q

Approx. 25% of adults who became chronically infected during childhood later die from what

A

Liver cancer or cirrhosis caused by chronic infection

27
Q

76% of all cases occur where

A

Asia, Africa, and South America

28
Q

Today in the US, there are ___ Americans infected with Hepatitis B and rates highest among ____ years of age

A

12 million; 25-44

29
Q

___ of all cases are sexually transmitted and ___ persons have chronic hepatitis B virus infection

A

~23%; 1.4 million

30
Q

How is Hepatitis B transmitted

A

Blood route, Sexual activities, Mother to newborn, and Casual contact

31
Q

What are the clinical courses Hepatitis B can take

A

Inapparent subclinical, Anicteric, icteric, Chronic, and Fulminant

32
Q

Which clinical course leads to death

A

Fulminant

33
Q

which clinical course has symptoms w/o jaundice

A

Anicteric

34
Q

which clinical course is asymptomatic

A

Inapparent subclinical

35
Q

Which clinical course has symptoms with Jaundice

A

Icteric

36
Q

What is the incubation period for Hepatitis B

A

range from 45-120 days

37
Q

How long could the preicteric period last and about when does the icteric phase begins

A

1 week; within 10 days

38
Q

What is the mortality rate for Hepatitis B

A

Overall infection .2-.5% and icteric only .2-1.5%

39
Q

___ of patients fail to clear virus from blood and become “carriers” of hepatitis B

A

2-10%

40
Q

Which two antigens indicates past infection

A

Surface and Core

41
Q

Which antigen induces protective neutralizing antibodies

A

Surface

42
Q

Which antigen correlates with active virus replication and may indicate chronic/carrier state

A

HBeAg

43
Q

What diagnostic can you conclude if IgM and HBc are shown

A

Most sensitive for acute infection

44
Q

What diagnostic can you conclude if IgG and HBs are shown

A

Indicates past infection, neutralizing antibody, and immune protection

45
Q

What diagnostic can you conclude if IgG and HBc

A

indicates past infection

46
Q

What diagnostic can you conclude if IgG and HBe

A

indicates acute infection, active virus replication, and chronic/carrier state

47
Q

Hepatitis B is _____ infectious than HIV-1

A

50-100 X more

48
Q

Compare concentration in blood of HIV to HBV

A

10^6-8 ;10^8-10

49
Q

Compare risk of infection of HIV to HBV

A

<.5% ; ~18%

50
Q

Compare survival in clinical specimen in HIV to HBV

A

90-99% Reduciton in hours ; up to 7 days

51
Q

What is the treatment for HBV

A

Prophylaxis: HB immune globlulin (HBIG), anti bodies that are made in someone else and harvested; No antiviral treatment for acute infection; Chronic infection is treated with interferon-alpha (a reverse transcriptase inhibitor)

52
Q

What is the history of the HBV vaccine

A

Dr. Maurice Hillemann used carriers of the HBV as a culture system to produce a commercial vaccine over a 14 year period

53
Q

___ stages need to extract Dane particles prior to animal tested and ____ weeks needed to make one batch of Dane particles.

A

7 ; 65

54
Q

Why did the production of Plasma derived vaccine stopped

A

due to fear of HIV infection

55
Q

After plasma derived vaccine stopped , how was the vaccine produced

A

using yeast that in which 3 intramuscular doses are needed

56
Q

how is Hepatitis A transmitted

A

Poor hygiene or sanitation, contamination of water or milk, consumption of contaminated raw oysters or clams, and blood transfusions but not associated with any physical contact of infected

57
Q

what is the incubation period of Hepatitis A

A

12-50 days avg 28

58
Q

Transition from feeling well to ill occurs ___ with Hepatitis A with a short preicteric phase

A

abruptly

59
Q

The icteric phase begins within ___ of initial clinical symptoms and is identified how

A

10 days; showing dark, golden urine followed days later with jaundice and pale stool. May have enlarged liver

60
Q

Covalescent period begins in ___ and is identified how

A

~7 weeks; symptoms of jaundice subsides

61
Q

Mortality rate is highest among __ yrs of age at ___ and over 70% of deaths in patients are what age

A

> 40; 2.1% ; 49

62
Q

Which antibodies are specific to HAV

A

IgM anti- HAV which peaks @ ~6 weeks after exposure then drops; IgG anti-HAV which peaks @ ~ 8 weeks after exposure and remains constant

63
Q

How is HAV treated

A

Passive administration of HIGB, effective when given up to 6 days prior to illness; two killed vaccines for prevention of HAV infection; no antiviral drugs

Infectious Diseases (9 decks)

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