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IAHI Block 3 > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q 
Name the viral infection. 
Diagnostic Test: 
-IgM anti-HAV, positive
-IgG anti-HBsAg, positive
-IgG anti-HBcAg, positive
A

Acute Hepatitis A; previous exposure to Hep B (vaccine)

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2
Q

Name the viral infection.
Diagnostic Test:
-IgM anti-HBsAg, positive
-IgM anti-HBcAg, positive

A

Acute Hepatitis B

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3
Q

Name the viral infection.
Diagnostic Test:
-IgM/IgG anti-HBsAg, positive
-IgM/IgG anti-HBcAg, positive

A

Chronic Hepatitis B

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4
Q 
Name the viral infection. 
Diagnostic Test: 
-RT-PCR anti-HCV, positive
-IgG anti-HBsAg, positive
-IgG anti-HBcAg, positive
A

Chronic Hepatitis C; previous exposure to Hep B (vaccine)

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5
Q

Name the viral infection.
Diagnostic Test:
-RT-PCR anti-HCV, positive
-ALT serum levels very high

A

Acute Hepatitis C

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6
Q

Symptoms of hepatitis (6). Which age group tends to be the most jaundiced?

A
  1. fatigue
  2. abdominal pain
  3. loss of appetite
  4. nausea/vomiting
  5. dark urine
  6. jaundice
    - Older age group (over 14)
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7
Q

Which two types of hepatitis do not persist in the liver (there is NO CHRONIC DISEASE)? Which causes the most chronic disease?

A

Hep A and Hep E; Hep C

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8
Q

You are a IV drug user; which type of hepatitis would you most likely get?

A

Hep C

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9
Q

You have lots of sex; which type of hepatitis would you most likely get? How long was your incubation period? What are your symptoms due to, primarily?

A
  • Hep B
  • about 2 months
  • cell mediated immune response (not virus!!)
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10
Q

You ate contaminated shellfish and are now having hepatitis symptoms; which type do you have and what kind of virus class is it?

A

Hep A; RNA Picornavirus (single serotype; +ssRNA, icosahedral, nonenveloped; transmitted fecal-oral)

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11
Q

Which hepatitis types have vaccines? Describe the vaccine for each and who can receive it.

A
  1. Hep A: inactivated vaccine (via formalin); people at risk for Hep A (infants, CKD, high endemic HAV)
  2. Hep B: VLPs; everyone at birth
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12
Q

You went swimming in the water in Mexico and swallowed some water and are now having hepatitis symptoms. Which kind of virus do you probably have? Is there a vaccine for this virus?

A
  • Hep E [Mexico = travel! and non person-to-person contact = drinking fecally-contaminated water]
  • No
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13
Q

What’s the incubation period of:

  1. Hep A
  2. Hep C
  3. Hep B
A
  1. Hep A = 3.5 weeks (virus shedding when asymptomatic)
  2. Hep C = about a month
  3. Hep B = 2 months
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14
Q

Name the virus Family for:

  • Hep A
  • Hep B
  • Hep C
  • Hep D
  • Hep E
A
  • Picornavirus
  • Hepadnavirus (enveloped, cDNA–partially ds)
  • Flavivirus (enveloped, +ssRNA, associated with VLDL)
  • none; needs HBV to replicate
  • Calicivirus (+ssRNA, icosohedral)
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15
Q

Why does Hep B have a variety of morphologies? Why is this good therapeutically?

A
  • Big round = virus
  • Rod-like = non-infectious HBsAg
  • Small round = non-infectious Dane particles
  • -Purpose is to act as decoys for the immune system to mount responses against other antigens other than the Hep B viurs
  • -HBsAg and Dane particles (VLPs) are the basis of Hep B vaccines
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16
Q

The ______ you are when you get Hep B, the more likely you are to get a chronic infection. Therefore the best treatment is _____.

A
  • younger

- prevention (vaccines!)

17
Q

Hep B: In the cytoplasm, how are new partially dsDNA strands made for packaging?

A

mRNA is reverse transcribed to ssDNA, which is then made into partially dsDNA

18
Q

Can Hep B DNA integrate into the cellular DNA?

A

Yes!

19
Q

The presence of _____ during a Hep B infection can increase the probability that you will get primary hepatocellular carcinoma [superinfection]. Describe this particle.

A
  • Hep D
  • Viriod and ribozyme that processes itself (with exception of host RNA poly); small RNA, encoding 1 antigen; packaged in Hep B sAg
20
Q

Why does HBV have a high correlation with hepatocellular carcinoma (HCC)? (4 reasons)

A
  1. Due to damage, liver undergoes sustained cell proliferation, which enables increased genetic errors
  2. Integration of viral DNA into host chromosome can cause genomic instability
  3. Virally-encoded “X” protein linked to oncogenic properties, like inhibiting p53
  4. HCC correlated with HBV surface antigen expression/X expression
21
Q

Error-prone viral RNA polymerases, like in Hep ___, lead to many ______. This makes it difficult to develop vaccines.

A
  • C

- quasi-species

22
Q

High incidence of both ____ (85%) and _____ infection allow Hep C to spread throughout the population. Hep C is also associated with increased onset of ______, primarily due to increased immune response.

A
  • Chronic
  • Asymptomatic
  • HCC (Hepatocellular carcinoma)
23
Q

What is the incubation time of Hep C? How do you know the difference between an acute and chronic infection? When do anti-HCV Abs appear? How do you treat Hep C genotype 1 (most prevalent in US)?

A
  • Less than a month
  • ALT levels!! ALT very very high with acute infection (1.5 months); ALT levels fluctuate with chronic infection
  • after about 4 months
  • Ribavirin + IFN
24
Q

Why does HCV have a high correlation with hepatocellular carcinoma (HCC)? (5 reasons)

A

IMMUNOREGULATION!!!

  1. HCV core protein inhibits p53/Rb)
  2. HCV core induces steatosis, leading to oxidative-stress-induced cell proliferation
  3. HCV envelope protein (E2) inhibits NK cells
  4. NS3 inhibits p53 to increase cell proliferation
  5. NS5A inhibits p53 to prevent apoptosis
25
Q

HCV requires a specific cellular component, present in liver cells, that binds the HCV genome and enhances its translation and/or replication. What is this component? Which drug targets this component?

A
  • cellular miRNA-122 (binds 2 sites in 5’UTR HCV genome)

- SPC3649 inhibits cellular miRNA

26
Q

Those with the ______ genetic polymorphism, which encodes ______ cytokine, has a strong correlation with the development of chronic infection of HCV.

A
  • IL28b gene

- IFN-gamma

27
Q

Name 3 Hep C virus-targeting drugs.

A
  1. Protease inhibitor ABT-450 with ritonavir (boost)
  2. NS5A inhibitor ABT-267
  3. NNRTI ABT-333

IAHI Block 3 (5 decks)

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