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hepatitis Flashcards

1
Q

inflammation of the liver leading to hepatocyte damage to the membranes causing leakage of AST and ALT. destruction of hepatocytes causes cell death and liver failure may ensure

A

hepatitis

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2
Q

possible outcomes of hepatitis (3)

A
  1. chronic infection due to a weak or immature host immune response leading to fibrosis
  2. recovery with a vigorous and immediate host response and the virus is cleared
  3. fulminant hepatitis with a too vigorous host response leading to widespread cell death and liver failure
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3
Q

clinical acute hepatitis

  1. incubation period
  2. prodrome
  3. acute illness
  4. recovery
A
  1. incubation period- long and asymptomatic
  2. prodrome- 2-10 days of flu-like symptoms. host very infectious
  3. acute illness- dark urine before jaundice or icterus is noticed with light colored stools. symptoms last 2-3 weeks
  4. recovery- stool color returns to normal and the systemic symptoms and jaundice abate
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4
Q

outcome of hep A and E

A

do not become chronic but may results in either recovery or fulminant

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5
Q

outcome of hep B, D and C

A

all can become chronic especially C and a superinfection of hep D on hep B

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6
Q

gold standard for assessing liver damage

A

liver biopsy

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7
Q

in chronic hepatitis are the symptoms resolved from the acute part of the illness?

A

yep but there is continued viral replication

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8
Q

which virus will have extra-hepatic manifestations?

A

hep B with skin rash, arthritis, vasculitis, glomerulonephritis, cryoglobulinemia

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9
Q

which hep. virus is jaundice minimal and transaminase elevations are <500- 1000

A

hep C

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10
Q

most common cause of acute hepatitis

A

HBV

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11
Q

most common cause of chronic hep

A

HCV

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12
Q

single stranded RNA virus that is fecal-oral transmission. It has a short incubation period of only 4 weeks but there is no chronic disease. vaccine is >90% efficacious

A

hep A

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13
Q

single stranded RNA virus that is fecal-oral transmission with a short incubation period of 4 weeks but there is no chronic disease. there is no vaccine. found in pigs

A

Hep E

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14
Q

acute hepatitis that might lead to fulminant hepatitis in 20% of pregnant women

A

Hep E

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15
Q

hep B transmission is

A

blood borne and there is a long incubation period of 2-3 months but it can be up to 6 months

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16
Q

all the hep viruses are RNA viruses except

A

HBV which is a DNA virus

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17
Q

The presence of _____ in the blood is the main marker for infection of hep B

A

HBsAg

  • marker for active infection and it will remain positive in chronic HBV carriers
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18
Q

who are more likely to get chronic HBV

A

older age

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19
Q

in recovery what is elevated in hep B

A

anti-HBs +

20
Q

which hep virus increases the chance of hepatocellular carcinoma

A

hep B but hep C also can cause it

21
Q

HBV has a vaccine?

A

yep, the vaccine is recombinant HBsAg so a vaccinated person has a protective ab, anti-HBs

22
Q

mother that have HBsAg (+) what should be given to the child?

A

HBIg and IBV vaccine

23
Q

immune tolerant phase HBsAg +

A

childhood

24
Q

inactive carrier phase HBsAg +

A

adult

25
Q

immune active phase HBsAg +

A

adult and this is the phase you need to treat!!!!

26
Q

whats the deal with HDV?

A

defective RNA virus that needs HBV for infection and replication. it is blood borne and it can be acquired with a co-infection with HBV simultaneously or it can lead to a superinfection of a previous infection of HBV, the later one has a higher chance of forming chronic hepatitis and fulminant hepatitis

**there is no treatment but prevented by HBV vaccination

27
Q

single stranded RNA virus that is transmitted through blood. it has a long incubation time of 2 months and there is clinically mild infection that causes little jaundice and low ALT elevations. There is a rapid progression to cirrhosis if one either drink alcohol or has HIV

A

Hep. C

28
Q

CDC recommendation if you are born between the ages s1945-1965

A

screen once with HCV antibody

29
Q

what does IgM mean?

A

active infection

30
Q

what does IgG mean?

A

past infection

31
Q

when is there a shift between IgM and IgG

A

around 4 months

32
Q

anti-HCV is protective?

A

nope

33
Q

anti-HBs is protective?

A

yep

34
Q

Anti-HAV is a combined capture assay measuring

A

both IgM and IgG

35
Q

HBeAg is a marker for

A

viral replication

36
Q

the presence of antibodies to hep. B _______ is the earliest host response to HBV antigen

A

core antigen

37
Q

duration of protection for HBV

A

10-15 yr

38
Q

presence of HBV-DNA

A

active replication

39
Q

total anti- HBc in hep B is made up of

A

IgG

40
Q

which Ig is present in chronic hep D

A

both IgM and IgG andti-HDV

41
Q

treatment of HDV

A

no specific treatment , control of HDV depends on preventing HBV infection by vaccination

42
Q

diagnosis of HCV 2 tests

A
  1. anti-HCV by EIA

2. HCV-RNA

43
Q

in acute viral hepatitis what doe we see? histo

A

portal and lobular mononuclear inflammation

  • balloning degeneration, apoptosis (bridging necrosis if severe), macrophage/kupffer cell aggregates, cholestasis but no fibrosis
44
Q

what do we see in chronic viral hepatitis? histo

A

portal and periportal predominant inflammation

  • development of fibrosis
45
Q

is there regression of fibrosis after successful treatment?

A

yep

46
Q

diffuse fibrosis/scarring with regenerative nodules and altered vascular architecture

A

cirrhosis

47
Q

which cell contributes sto hepatic fibrosis

A

stellate cell

GI (26 decks)

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