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Jason's GI Block > Hepatitis 2 > Flashcards

Hepatitis 2 Flashcards

1
Q

Which hepatitis has a 30-50% perinatal infection rate if untreated?

A

hepatitis B

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2
Q

hepatitis B and C are transmitted mainly how?

A

sexual and IV drug

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3
Q

what are you chances of getting hepatitis C if you are IV user?

A

50-60%

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4
Q

hepatitis is ___ times more prevalant than HIV in Australia

A

18 times

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5
Q

hepatitis is ___ times more prevalant than HIV in Victoria

A

16 times

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6
Q

hepatitis B has how many walls? nonenveloped?

A

double walled with outer envelope and inner capsid

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7
Q

What are HBsAG particles?

A

Hepatitis B Surface Antigen particles (incomplete viruses)

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8
Q

Hep B preGenome has own polymerase?

A

Yes, pregenomic RNA

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9
Q

describe the extracellular Hep B genome? ds? ss? RNA? DNA?

A

dsDNA

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10
Q

4 general different reading frames for Hep B coding

A

core (c)
surface(s)
polymerase(p)
X

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11
Q

Why do you get lots of mutant Hep B viruses?

A

reverse transcription from RNA to dsDNA has a high error rate

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12
Q

Hep B penetration is where?

A

mucosal epithelia

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13
Q

Hep B replication is where?

A

Liver

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14
Q

High concentration of Hep B in body fluids? 3 places

A

blood
serum
wound exudates

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15
Q

Moderate concentration of Hep B in body fluids? 3 places

A

semen
vaginal fluid
saliva

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16
Q

3 Hep B modes of transmission:

A

Sexual
Parenteral-needle stick
Perinatal

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17
Q

Which moms are more likely to transmit Hep B perinatally?

A

HBeAg positive ‘e antigen’

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18
Q

Hep B incubation period?

A

60-90 days

45-180 day range

19
Q

Hep B jaundice by age? why?

A

5

dictated by immune response

20
Q

which group has higher chronic infection of Hep B?

A

<5yr olds 30-90%

21
Q

General trends for outcome of Hep B with age?

A

the younger you are, the more likely to have chronic Hep B infection but more asymptomatic. The older you are, the more symptomatic but the less chronic infection

22
Q

Natural history of chronic Hep B infection? how long?

A 
acute
chronic hepatitis
cirrhosis
liver cancer
death
30-50 years
23
Q

Hep B recovery serology looks like how?

A

initial rise in IgM and HBsAg
Then as IgM goes down you have increased and sustained:
Anti-HBs (surface protein)
anti-HBc (core protein)

24
Q

In chronic Hep B serology, what is missing?

A

Missing Anti-HBs

there is Anti-HBc

25
Q

Why is a missing Anti-HBs bad for chronic Hep B?

A

the existing Anti-HBc is a poor anti-HBs so it persists

26
Q

Chronic carrier of Hep B has what serology marker?

A

HBsAg positive

27
Q

what is the most common cause of liver cancer?

A

Hep B sequelae

28
Q

% of Hep B lifetime mortality?

A

~30%

29
Q

How long from infection to cancer for Hep B?

A

10-30years

30
Q

How much more likely are you to get hepatocellular carcinoma with Hep B carriers?

A

100x yo….

31
Q

HBeAg indicates what?

A

active replication

32
Q

HBsAg indicates?

A

general marker for infection

33
Q

What is a marker of acute Hep B infection?

A

rising anti-HBc IgM

34
Q

What is a marker of past or chronic Hep B infection?

A

anti-HBc IgG

35
Q

when do you use HBV-DNA testing?

A

indicates active replication

used for escape mutants

36
Q

3 current treatments for Hep B?

A 
interferon alpha pegylated
nucleoside/tide analogues
new NCTP (sodium co-transporting polypeptide)
37
Q

what kind of drugs are adefovir, tenofovir? for what? what do they target?

A

Hep B
nucleotide analogues
target polymerase function

38
Q

What is 3TC/Lamivudine?

A

nucleoside analogue (no phasphate group)

39
Q

Hep B vaccine is now cultured from?

A

yeast

40
Q

Hep B vaccine protects from what? how many doses?

A

Hep B
Hep D
2-3 doses

41
Q

how is Hep D like Hep B?

A

ssRNA with a delta antigen and encased in the Hep B surface antigen

42
Q

How can you catch Hep D?

A

only infects in conjunction with Hep B

43
Q

What happens when you get HBV and HDV coinfection?

A

severe acute disease

low risk of chronic infection

44
Q

what happens in a HDV superinfection?

A

HDV after an already HBV+

get chronic HDV and liver infection

Jason's GI Block (32 decks)

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