hepatitis

Question 1

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

Answer 1

hepatitis

Question 2

possible outcomes of hepatitis (3)

Answer 2

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

Question 3

clinical acute hepatitis

1. incubation period
2. prodrome
3. acute illness
4. recovery

Answer 3

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

Question 4

outcome of hep A and E

Answer 4

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

Question 5

outcome of hep B, D and C

Answer 5

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

Question 6

gold standard for assessing liver damage

Answer 6

liver biopsy

Question 7

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

Answer 7

yep but there is continued viral replication

Question 8

which virus will have extra-hepatic manifestations?

Answer 8

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

Question 9

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

Answer 9

hep C

Question 10

most common cause of acute hepatitis

Answer 10

HBV

Question 11

most common cause of chronic hep

Answer 11

HCV

Question 12

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

Answer 12

hep A

Question 13

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

Answer 13

Hep E

Question 14

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

Answer 14

Hep E

Question 15

hep B transmission is

Answer 15

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

Question 16

all the hep viruses are RNA viruses except

Answer 16

HBV which is a DNA virus

Question 17

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

Answer 17

HBsAg

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

Question 18

who are more likely to get chronic HBV

Answer 18

older age

Question 19

in recovery what is elevated in hep B

Answer 19

anti-HBs +

Question 20

which hep virus increases the chance of hepatocellular carcinoma

Answer 20

hep B but hep C also can cause it

Question 21

HBV has a vaccine?

Answer 21

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

Question 22

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

Answer 22

HBIg and IBV vaccine

Question 23

immune tolerant phase HBsAg +

Answer 23

childhood

Question 24

inactive carrier phase HBsAg +

Answer 24

adult

Question 25

immune active phase HBsAg +

Answer 25

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

Question 26

whats the deal with HDV?

Answer 26

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

Question 27

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

Answer 27

Hep. C

Question 28

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

Answer 28

screen once with HCV antibody

Question 29

what does IgM mean?

Answer 29

active infection

Question 30

what does IgG mean?

Answer 30

past infection

Question 31

when is there a shift between IgM and IgG

Answer 31

around 4 months

Question 32

anti-HCV is protective?

Answer 32

nope

Question 33

anti-HBs is protective?

Answer 33

yep

Question 34

Anti-HAV is a combined capture assay measuring

Answer 34

both IgM and IgG

Question 35

HBeAg is a marker for

Answer 35

viral replication

Question 36

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

Answer 36

core antigen

Question 37

duration of protection for HBV

Answer 37

10-15 yr

Question 38

presence of HBV-DNA

Answer 38

active replication

Question 39

total anti- HBc in hep B is made up of

Answer 39

IgG

Question 40

which Ig is present in chronic hep D

Answer 40

both IgM and IgG andti-HDV

Question 41

treatment of HDV

Answer 41

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

Question 42

diagnosis of HCV 2 tests

Answer 42

1. anti-HCV by EIA | 2. HCV-RNA

Question 43

in acute viral hepatitis what doe we see? histo

Answer 43

portal and lobular mononuclear inflammation - balloning degeneration, apoptosis (bridging necrosis if severe), macrophage/kupffer cell aggregates, cholestasis but no fibrosis

Question 44

what do we see in chronic viral hepatitis? histo

Answer 44

portal and periportal predominant inflammation - development of fibrosis

Question 45

is there regression of fibrosis after successful treatment?

Answer 45

yep

Question 46

diffuse fibrosis/scarring with regenerative nodules and altered vascular architecture

Answer 46

cirrhosis

Question 47

which cell contributes sto hepatic fibrosis

Answer 47

stellate cell