Hepatitis

Question 1

Common clinical features of viral hepatitis

Answer 1

Anorexia
Icterus
Jaundice (HALLMARK OF INFX)
Pain in right side of abdomen and in joints
Increased weakness, nausea, fever

Question 2

Fecal oral

Answer 2

Hepa A and E

Question 3

Parenteral

Answer 3

B, C and D

Question 4

____: major cause of infectious hepa
____: major cause of serum hepa

Answer 4

A, B

Question 5

defective virus dependent on coinfection with HBV

Answer 5

HDV

Question 6

Parenteral NANB and enteric NANB

Answer 6

HCV, HEV

Question 7

Hepa belonging to flaviviridae

Answer 7

HCV, HGV*

HGV and TTV are transfusion assoc viruses, no liver inflamm= not hepa 🍹

Question 8

unenveloped, ssDNA virus that shares its characteristics with parvoviruses and circoviruses

Answer 8

TTV

Question 9

Clinical phases of hepatitis

Answer 9

Incubation/preclinical
Prodronal
Icteric
Convalescent

Question 10

Characterized by active replication, asymptomatic but infectious

Answer 10

Incubation/Preclinical phase

Question 11

Pateinets experience fever, fatigue, vomitting, diarrhea, abdominal pain, loss of appetite, dark urine, pale stools

Answer 11

Prodronal

Question 12

Jaundice, infectious feces, viremia terminates

Answer 12

Icterus

Question 13

Complete recovery but slow resolution of disease or relapsing hepatitis

Answer 13

Convalescent

Question 14

Family: Picornaviridae
Genus: hepatovirus
Most common cause of acute viral hepatitis A and common foodborne infxn

Answer 14

Hepatitis A

Question 15

T or F: Hepatitis A causes chronic infxn

Answer 15

False

Question 16

Main reservoir of hepa A

Answer 16

Young children

*children are usually asymptomatic

Question 17

Icosahedral (+) sense ssRNA with Vpg at 5’ end of RNA
Acid, heat and dry resistant
Uses RNA dependent RNA polymerase

Answer 17

Hepa A

Question 18

Hepa A is inactivated by

Answer 18

Inactivated by: → Heating to 85°C for 1 min → Autoclaving at 121°C for 20 min → UV radiation of 1.1 W at a depth of 0.9 cm for 1 min → 8% formalin for 1 min at 25°C → Chlorine containing compounds § 3-10 mg/L sodium hypochlorite at 20°C for 5-15 min → Shellfish from contaminated areas should be heated to 90°C for 4 min or steamed for 90 sec

Question 19

T or F: the non-structural proteins of hepa A are immunogenic

Answer 19

True

Question 20

Symptoms in children and adults for hepa A

Answer 20

Children: diarrhea nausea vomitting
Adults: jaundice abdominal pain

Question 21

Pathogenesis of Hepa A

Answer 21

Ingestion>replication in oropharynx and GIT > replication in liver (major site) > shed in bile > shed in feces > BRIEF viremia> cellular immune response

Question 22

Shows recent (4-6 months) infxn

Answer 22

Anti-HAv IgM

Question 23

Pre-exposure vaccination for hepaA

Answer 23

HAVRIX AND TWINVIX ghavrix with engerix-b)

Question 24

What is administered to thos under 2 yo with hepa A

Answer 24

AntiHAV immune globulin

Question 25

Family: heparnaviridse Genus: orthohepadnavirus Enveloped, icosahedral, circular, partially double stranded DNA Can cause acute and chronic

Answer 25

Hepatitis B

Question 26

Three morphological forms of hepa B

Answer 26

Dane particle -only form with DNA Filamentous particle-non-infectious Spherical particle-non-infectious (most common)

Question 27

Antigenicity of Hepa B

Answer 27

HbsAg- highly immunogenic (humoral on,y) HBeAg- soluble HBcAg- does not exist in free form

Question 28

Persists for at least 6 months which defines a chronic carrier

Answer 28

Hbsag

Question 29

Its presence is the best indicator of active viral replication

Answer 29

HBV DNA

Question 30

Useful marker of viral replication

Answer 30

HBeAg

Question 31

Provides protective immunity Indicates recovery from acute Hep B or immunization from HBV vaccine

Answer 31

Anti-Hbs antibody

Question 32

Offers no immunity

Answer 32

Anti-HBc

Question 33

Appears after Hbsag is cleared, indicates stopped viral replication

Answer 33

Anti-HBe

Question 34

HB Recombinant vaccines are made up of

Answer 34

Clones of S genes inserted into yeast cells

Question 35

Family: Flaviviridae Genus: Hepacivirus Most prominent cause of transfusion associated hepatitis Icosahedral enveloped (+) ssRNA With INTERNAL RIBOSOME ENTRY SITE (entry of ribosomes and translation)

Answer 35

Hepatitis C

Question 36

Hepatitis C is inactivated by

Answer 36

1-propanol | 80-95 secs at 67-70 C

Question 37

Hcv rna disappears, ALT goes up

Answer 37

Acute hcv

Question 38

Hcv rna persists long time, ALT rin

Answer 38

Chronic hep c

Question 39

Enveloped circular (-) sense ssRNA RNA Polymerase II Highly defective (no virions produced) -HBV prodvides HBsAg protein

Answer 39

Hepa D

Question 40

``` Family: Herpeviridae Genus: Orthoherpevirus Species: Orthoherpevirus A Non-enveloped (+) sense ssRNA ORF 1-3 4 Genotypes ```

Answer 40

Hepatitis E

Question 41

4 Genotypes of Hepa E and what they infect

Answer 41

1: humans and pig 2: humans 3 and 4: animals esp 🐷 (sporadic autochtonous infxn)

Question 42

ORF funx

Answer 42

1: viral replication (NSP) 2: virion capsid (SP) 3: viral egress

Question 43

Chronic hepatitis E is characterised by

Answer 43

High alt levels Presence of HIV rna Histological findings *Usually caused by genotype 3

Question 44

Gold standard for confirming acute HEV infxn

Answer 44

Detection of HEV RNA from stool (1 wk-6wks after onset of symptoms) and serum (3-4 weeks after onset of symptoms)

Question 45

Chinese manufactured vaccine successful against genotypes 1 and 4, idk on 3

Answer 45

HEV 239 hecolin

Question 46

Treatment for HEV for transplant patients but with side fx

Answer 46

Pegylated interferons

Question 47

Treatment for acute HEV in immunocompromised

Answer 47

Ribavirin