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Med Lab Test 2 > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

Hep A

A

RNA virus. It is not cytopathic to hepatocytes, it just causes liver injury by stimulating both cellular and humoral immune responses.

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2
Q

How is Hep A transmitted?

A

F/O (assoc. with poor hand washing, inadequate sanitation, day care centers, etc)

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3
Q

How are epidemics of Hep A caused?

A

via waterborne or food borne…ie someone poops in a field and it spreads

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4
Q

T/F: there is a vaccine for Hep A?

A

true, it should be given when traveling to endemic areas and a booster is given at 1 year.

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5
Q

What are the symptoms of Hep A?

A

flu-like complaints–> abdominal pain, diarrhea, fatigue, fever, HA, myalgia, arthralgia), onset and abrupt (may include nausea and vom) usually lasts around 2 weeks. often missed. jaundice in adults self limited. most recover fully.

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6
Q

when does the Hep A antibody appear?

A

4 weeks after infection (IgM= acute 1-8 weeks, then IgG=past infection,>2 months). virus is in blood briefly and shed in stool.

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7
Q

How can you monitor the Hep A disease?

A

with liver enzymes and bilirubin. AST, ALT >3ULN. (500-1000). Urine bilirubin will be positive.

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8
Q

What kind of virus is Hep B?

A

DNA virus. (circulates as several particles called “dane” particles”

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9
Q

Is Hep B serious?

A

yes, infected patients manifest Hep B in virtually all body fluids. It can cause around 200,000-300,000 thousands death per year.

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10
Q

What body fluids can you find Hep B in?

A

all of them

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11
Q

How do you get Hep B?

A

its a blood borne pathogen so, from needles, body peircings, sexually. blood transfusions are screened.

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12
Q

How many doses is the Hep B vaccine?

A

Active immunization: 3 at 0,1,6 months since first dose. some people never convert. passive immunity can be conferred with HBIG.

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13
Q

Do all people recover from Hep B?

A

no, some progress to fulminant. chance of chronic is higher if you are younger.

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14
Q

What are the symptoms of Hep B?

A

onset can last 1.5-6 months. abdominal pain, diarrhea, fatigue, hepatomegaly, n/v, jaundice (30-50% of adults), urine is dark amber color.

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15
Q

What is HBsAg?

A

surface antigen, most widely used marker for Hep B. appears at 14 days, gone by 4 months.

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16
Q

HBcoreAg

A

found the core of the intact virus, no lab test for this.

17
Q

HBcoreAB: 2 tests available

A
  1. HBcoreAB-IgM: acute marker, becomes undetectable within 1-2 months. active disease. >6 months = chronic
  2. HBcoreAB-total: detects IgG and IgM. Indicates a previous infection. This is not a protective antibody.
18
Q

What is the core window?

A

occurs when B surface antigen (HBsAg) is negative but the antibody (HBsAB) hasn’t been produced yet. The HBcoreAB-IgM will be positive.

19
Q

What is the last antibody to appear, indicates clinical recovery form HBV and is the only marker found in those with the vaccine for HB?

A

HBsAB, it confers lifelong immunity to the HBV infection. “the surface antibody”

20
Q

which virus requires a co infection with Hep B to replicate?

A

Hep D. It is an RNA particle virus.

21
Q

What is the preferred marker for Hep D infection?

A

HDVAB (not HDVAg because it will only stay elevated a few days.) Does not confer immunity, people can still transmits infection.

22
Q

T/F: there is a vaccine for Hep D?

A

FALSE! no vaccine. highly infectious, no immunity. Associated with drug abuse. very poor prognosis.

23
Q

Which RNA virus has a high rate of mutation in genes of the envelope protein?

A

Hep c (hep b has a rare mutation rate). It allows the virus to “hide” in the body.

24
Q

What is the most common cause of chronic hepatitis in NA, Europe, and Japan?

A

Hep C

25
Q

Most with Hep C infection develop…what?

A

a chronic infection, (>80%) and its leads to serious liver problems down the road. cirrhosis in about 20 years.

26
Q

How is Hep C transmitted?

A

body fluids, mainly blood.

27
Q

T/F: there is no vaccine for Hep C?

A

true, no completely effective treatment either. you need a liver transplant.

28
Q

Is a Hep C antibody protective?

A

No! patients are still considered to be infected

29
Q

What are you looking for when testing for the presence of the HAVAB?

A

HAVAB-IGM (Acute infection)

HAVAB-Total (IgM and IgG, past infection)

30
Q

who all should get the Hep B vaccine?

A

babies, adolescents and college students at increased risk when practicing risky life styles or sports.

31
Q

If someone has been exposed to Hep B, what should they be given?

A

HBIG, within 24 hours. It is a titer agasint HBsAg.

32
Q

What is HBeAg:

A

It is the envelop antigen. It is RARELY used as marker. It is typically used in patients with chronic HBV and in HBV carriers. active replication, high infectivity.

33
Q

What is HBeAB?

A

envelope antibody. Typically used in patients with chronic HBV and HBV carriers. Indicates clearance of HBeAg. Could be used to see if treatment is working.

34
Q

What would be a clinically significant measure of HBV Dna?

A

> 100,000

35
Q

can you tell if someone has a Hep C infection right away?

A

No there is an incubation period of 14-180 days.

36
Q

What are the symptoms of Hep C?

A

majority are asymptomatic, maybe have vague flu like symptoms or jaundice.

37
Q

T/F: all patients will have elevated liver enzymes with a Hep C infection?

A

false.

AST and ALT levels fluctuate widely after infection. Almost 1/3 of patients with chronic HCV have normal liver enzymes.

38
Q

What are some tests to eval liver function?

A 
AST, ALT (hepatocellular)
LD
ALT, GGT (hepatobiliary)
TSP, albumin (made in liver)
Bilirubin
Coag factors: produced in liver, patient may bleed easily. 
UA: color bc of bilirubin

Med Lab Test 2 (9 decks)

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