hepatitis

Question 1

travelers diarrhea medication

Answer 1

floxacins (norlofxacin not recommended)
azithromycin (can send them with rx)
rifaxamin

Question 2

sx hepatitis

Answer 2

malaise 
n/v/abd pain 
ha 
muscle joint pain 
rash itching

Question 3

hepatitis objective findings

Answer 3

jaundice 
fever 
hepatosplenomegaly 
tender liver 
rash 
elevetated LFT
dark urine 
clay colored stool 
lymphocytosis

Question 4

hep A transmission
risks

chronic infx?

Answer 4

oral-fecal
risks: contaminated food-water, travel
MSM, drug abuse

no chronic infx

Question 5

hep A incubation
shedding ___ wks prior and ___ wk after sx
how long do sx last?
presentation?

Answer 5

28 d
2 weeks prior and 1 week after sx
2 weeks- several months
present with viral GI then jaundice

Question 6

hep A lab test

Answer 6

anti-HAV with igm during acute

Question 7

hep A immunity after infx?

Answer 7

most recover and will be immune

Question 8

prevention of hep A
prexposure:
postexposure:
other:

Answer 8

preexposure: vaccine (2 doses)
post: vaccine and/or immune globulin within 2 weeks of exposure
other: good hygiene clea water

Question 9

preexposure vaccination with hep A

40 or immunocompromised

Answer 9

40 or comorbidities- 2 weeks before or vaccine + immune globulin

Question 10

hep B transmission

risks

Answer 10

bloodborne percutaneous permucosal sexually transmitted

risks: sex, IVDA, maternal-child, health care

Question 11

hep b 
incubation 
how long does it last? 
30-50% are \_\_\_\_\_\_\_\_ 
chronic infx= risk factor for\_\_\_\_\_\_\_
PEP:

Answer 11

90 days 
4-6 weeks acute 
30-50% are asymptomatic 
chronic infx= risk factor for carcinoma 
PEP: within 24 hours of exposure

Question 12

hep B serology
HBsAG=
HBsAB=
anti-HCB AKA _____=

Answer 12

HBsAG= person infected
HBsAB= immune (immunized or disease)
anti-HCB AKA HBcAb= positive infection past or present

Question 13

HBsAG -
HBsAB +
HbcAb/anti-HCB -

HBsAg-
HBsAb +
HbcAb/anti-HCB +

Answer 13

not infected
immune
no current or past infection, got vaccinated

not infected
immune
previously infected

Question 14

HBeAg is associated with

HBeAb is associated with

Answer 14

high infectivity, bad prognosis

lower infectivity, shows up early then lower infectivity

Question 15

Hep B vaccination
ages

testing

Answer 15

through 18 or 18+ and high risk (HCW, hemodialysis, multiple sex partners, correctional, MSM, IVDU)

pre- not recommended
post- 1-2 months after for HCW

Question 16

Hep B tx

Answer 16

refer to GI

acute: supportive
chronic: dont memorize meds

Question 17

Hep C transmission
risks:
chronic?

Answer 17

bloodborne, percutaneous, permucosal
risks: IVDA, blood product before July 1992, clotting before 1987, birth mother
chronic 75-85%

Question 18

hep c incubation
most do not present with _____
major cause of ______
risk factor for_____

Answer 18

4-12 weeks
most do not present with acute illness
major cause of liver failure
risk factor for hepatocellular carcinoma

Question 19

Hep C prevention 
there is no\_\_\_\_ 
-drugs?
-sharing?
- HCW:
- sexual?

Answer 19

there is no vaccine 
IVDA: stop, clean 
do not share razors, toothbrush 
hcw: sharps, universal precautions 
sexual transmission rare, condoms

Question 20

Hep C serology

Answer 20

anti-HCV then HCV RNA if positive

Question 21

Treatment hep C
dx: 
referral: 
nonpharmacologic:
pharmacologic:

Answer 21

liver biopsy genotype
refer to GI
no ETOH, immunization against hepatitis
pharm: sovaldi, olysio (80-95%) pegylated interferon/ribivirin (40-80%)

Question 22

Factors that increase progression of hepatitis C
-
-
-
-

Answer 22

• ETOH
• > 40
• HIV or Hep B
• male

Question 23

Hepatitis C testing
-
-
-
-

Answer 23

• 1945-1965
• IV drug users
• medical conditions (clotting before 1987, chronic hemodialysis, liver disease)
• transfusion/organs (before 1992)

Question 24

Hepatitis D 
transmission
risks
vaccine
chronic

Answer 24

bloodborne
hepatitis B (need B to have D)
no vaccine
yes chronic infection

Question 25

Hepatitis E 
transmission 
risk 
vaccine 
chronic

Answer 25

oral-fecal (similar to A)
developing world
no vaccine
no chronic infection

Question 26

Liver function tests
AST: also found in 
ALT
Alk phos 
Bili

Answer 26

AST: statin/scotch- rises fast, clears quickly, also found in heart/muscle/brain/kidneys
ALT: hepatitis/liver, specific, persists
alk phos: gallbladder
Billi: elevated in hepatitis, jaundice + 2.5