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U6 micro > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

Which Hep Viruses have vaccines available?

A

A, B and E

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2
Q

List some non-infectious causes of Hepatitis

A

Rx rxns, Rx interxn, Acetaminophen OD, Ecstasy

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3
Q

What is the transmission of HAV

A

fecal oral through contaminated drinking water

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4
Q

Hep A virology

A

picornavirus

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5
Q

What are the risk factors for HAV infection

A

elderly, preexisting liver disease, recent travel

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6
Q

What is the cause of symptoms in HAV infection

A

slight hepatotoxicity, mostly immunogenic

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7
Q

Dx Hep A: exam

A

Jaundice, smokers complain about taste of tobacco, fatigue/fever, N/V, dark urine w/ pale feces, hepatomegaly w/ tenderness

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8
Q

Dx Hep A: history

A

Vaccinated? travel? daycare? shellfish? institutionalized? MSM? IV drugs?

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9
Q

Dx Hep A: lab

A

Enzyme Immunoassay

  • elevated bili, Asp ATF, alk phos
  • ultrasound biopsy if in liver failure
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10
Q

Interpret: positive anti-HepA IgM

A

acute infection

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11
Q

Interpret: positive anti-HepA IgG

A

past infection OR vaccination

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12
Q

Hep A prophylaxis

A

immune serum globulin (gammaguard)

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13
Q

Hep E virology

A

small, naked, ssRNA virus

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14
Q

how is Hep E transmitted

A

fecal-oral and waterborne

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15
Q

In which countries/continents is Hep E the most common cause of acute hepatitis

A

Asia, Africa and Mexico

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16
Q

What are the complications of Hep E in pregnancy

A

fatal fulminant hepatitis, encephalopathy, DIC

17
Q

Dx Hep E: exam

A

Biphasic
Prodrome: fatigue, fever, NV, hepatosplenomegaly w/ tenderness
Icteric: jaundice, dark urine, pale feces

18
Q

Dx Hep E: lab

A

Send to the CDC

  • high ALT, AST, and bili w/ negative AB tests for other hep viruses
  • US to rule out biliary obstruction
19
Q

Prevent Hep E

A

when traveling, boil water, cook shellfish, clean/cook produce

20
Q

Which hepatitis virus is a DNA virus?

A

Hep B

21
Q

Hep B virology

A

hepadnavirus, small enveloped DNA virus

22
Q

What is unique about hep B’s replication?

A

even though it is a DNA virus, it uses a reverse transcriptase

23
Q

How is hep B transmitted

A

contaminated blood, sexual or birth contact

24
Q

What is the pathogenesis of cirrhosis in chronic HBV infection

A

ongoing cytotoxic T cell response against infected hepatocytes

25
Q

What is the pathogenesis of hepatocellular carcinoma in chronic HBV infection

A

expression of viral transcriptional transactivators that have been integrated into the host genome

26
Q

What is the most common presentation of HBV infection in the US

A

Asian born adult infected vertically as a newborn

27
Q

Dx acute HBV: exam

A

Fatigue, jaundice, NV, RUQ pain, myalgia, encephalopathy, sleep disturbance, confusion coma

28
Q

Dx chronic HBV: exam

A

gynecomastia, spider angioma, caput medusa, peripheral edema, testicular atrophy

29
Q

Dx HBV: lab

A

Serology panel

biopsy if chronic

30
Q

Prevention of Hep B

A

Vaccination is best, then antibody prophylaxis after exposure

31
Q

Treatment of chronic Hep B

A

1yr of polymerase inhibitors PLUS 4mo of pegylated alpha-interferon

32
Q

Hep D virology

A

not a complete virus, ‘viriod’, can’t replicate by itself, can only replicate in cells co-infected w/ HepB

33
Q

Hep C virology

A

human restricted flavivirus w/ enveloped RNA genome

34
Q

How is hepC transmitted

A

blood, sex

35
Q

What is a red flag in a patients history suggesting HCV infection

A

travel to egypt (blood fluke eradication gone wrong)

36
Q

Extrahepatic signs of HCV

A

sicca syndrome, paresthesias, sensory loss, arthralgia, myalgia, pruritus

37
Q

Dx HCV: lab

A

EIA followed by RIBA, genotyping

38
Q

Where is there no HCV vaccine

A

antibodies are not protective

39
Q

HCV antivirals

A

Ribavirin (chain terminator), Pegylated-alpha-interferon, HCV protease inhibitors (‘previr’)

U6 micro (6 decks)

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