Hepatitis

Question 1

Liver enzymes increased during acute viral hepatitis include

Answer 1

The aminotransferases (AST and ALT) are increased in acute and chronic hepatocellular jaundice (hepatocellular damage). Gamma-GT and alkaline phosphatase are increased in posthepatic jaundice.

Question 2

The form of viral hepatitis that does not cause a chronic form of hepatitis is Hepatitis:

Answer 2

A

Question 3

The Hepatitis B serologic marker developed after vaccination conferring immunity is:

Answer 3

HBsAB

Question 4

A positive HCVAB does not indicate

Answer 4

Immunity

Question 5

Testing for Hepatitis D is performed when:

Answer 5

Hep B infection confirmed. Hepatitis D is dependent on Hepatitis B for replication. There is no need to test for Hepatitis D if Hepatitis B infection has been ruled out.

Question 6

The first antibody to appear during acute Hepatitis B is:

Answer 6

HBcoreAB-IgM

Question 7

Discuss formation of bilirubin

Answer 7

a. HGB → unconjugated bilirubin bound to albumin reversibly (not h2o soluble, toxic, not through memb) → bilirubin is dissociated from albumin and then is conjugated with glucuronic acid by glucuronyl transferase (CONJUGATED–water soluble, non toxic, and pass through the memb to urine) → conjugated bili in the intestine is converted to urobilinogen. Some of it is absorbed from the colon to systemic circulation and some is released in urine and feces. If found in plasma then liver injury!

Question 8

Predominant source of bilirubin in plasma is from what?

Answer 8

Predominant source of bilirubin in the plasma is aged or damage red blood cells.

Question 9

How is Hep A transmitted?

Answer 9

Fecal oral route

Question 10

Onset and symptoms of Hep A

Answer 10

Abrupt onset. Self limiting. Flu sxs to start. Majority are jaundice and have urine that is amber.

Question 11

Presence of HAVAB-total mean what?

Answer 11

Past infection

Question 12

Onset and symptoms of Hep B

Answer 12

• Onset is insidious and sometimes lasting 1.5 to 6 months. Over half are asymptomatic or only have mild-flu like sxs. Not all recover from acute disease. There are people who are carriers of the disease.
• Sxs are flu-like but more severe than HAV with liver enlargement/tenderness. Also have jaundice and amber urine.

Question 13

First serological marker to appear around 14 d. in hep B

Answer 13

HBsAG (surface antigen

Question 14

HBcoreAg (core antigen): found where?

Answer 14

In the virus not in the serum

Question 15

Most commonly detected marker in Hep B. No immunity to HBV

Answer 15

HBcoreAB

i. HBcoreAB-IgM: acute marker. Indicates that the infectivity is decreasing but the disease is still active.
ii. HBcoreAB-total: Detects IgG (and IgM if present). Previous infection.
iii. **Core window: may be only marker to indicate acute HBV infection. Period of time when HBsAg is negative or not detectable and HBsAB is not present and HBcoreAB-IgM is positive (patient is infected)

Question 16

Indicates clinical recovery from the infection and confers lifelong immunity! Found if vaccinated!

Answer 16

HBsAB

Question 17

Marker typically used in pts with chronic HBV and carriers.

Answer 17

HBeAg

Question 18

Marker typically used in pts with chronic HBV and carriers. Indicates clearance of HBeAg and decreasing viral replication.

Answer 18

HBeAB (envelope antibody)

Question 19

T/F: In Hep D… Markers aren’t usually detected. Highly infectious and no vaccine or immunity available. Blood borne. Poor prognosis and more serious than HBV

Answer 19

True

Question 20

T/F: The Serological marker in Hep C is HCV antibody and it confers immunity.

Answer 20

False- Serological marker is HCV antibody. Not protective. It is used to diagnose.