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D&T test 7- GI > Hepatitis A,E,C > Flashcards

Hepatitis A,E,C Flashcards

1
Q

What are the families of A, E, C, respectively

A 
A = picorna
C = flavi
E = hepe
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2
Q

A, C, E: naked or enveloped

A 
A = naked
C = enveloped
E = naked
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3
Q

what do each of the viruses do mnemonic:

A 
A= acute
B = blood borne
C = chronic
D = defective
E = enteric
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4
Q

Family and genetic material for HAV

A

Picornavirus family, +ssRNA, Naked

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5
Q

How can you kill HAV

A

heated to 185F for one minute to inactivate. (withstands heating to 140F for 10 hours)

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6
Q

What age group gets jaundice with HAV

A

Infection < 5 yo = no symptoms

Adult infx = jaundice

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7
Q

WHat is main transmission route for HAV

A

Person to person spread, though close personal contact or sex, is main transmission route.

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8
Q

Is there chronic HAV? does infx –> immunity?

A

no chronic infx

infx –> lifelong immunity

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9
Q

What is incubation time for HAV

A

Incubation Mean 4 weeks (2 to 6 weeks)

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10
Q

When is a person is very infectious with HAV

A

2 weeks before symptoms and one week after becoming jaundiced

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11
Q

When is someone Most infectious with HAV

A

MOST infectious 2 weeks before sx start!!!

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12
Q

What is the diagnostic test for acute HAV infection

A

IgM

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13
Q

What are the major complications of HAV? (3)

A

a. Relapsing Hepatitis
b. Prolonged cholestasis or cholestasis hepatitis
c. Fulminant hepatitis

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14
Q

Which age group has more serious infx?

A

over 50

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15
Q

What kind of vaccine is the HAV vaccine

A

whole killed-virus vaccine with alum added

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16
Q

How many doses are required for HAV vaccine

A

2

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17
Q

Which groups should get the HAV vaccine. (7)

A
  1. all children between the ages of 12 and 23 months.
  2. Travelers to endemic countries-
  3. Men who have sex with men
  4. IV and non-IV drug users
  5. People who have chronic liver disease, HBV or HCV
  6. close contacts of adopted children from countries with high or intermediate levels of HAV.
  7. People who receive clotting factors
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18
Q

Under 12 months or over 40 years what do you do instead of HAV vaccine?

A

give pooled IG.

19
Q

What do they give you if you are exposed to HAV

A

vaccine and/or pooled immunoglobulin within 2 weeks of exposure.

20
Q

What do they give you if you are exposed to HAV and are between 12 months to 40?

A

only vaccine

21
Q

Major source of infection for HEV

A

sewage infected water = contaminated drinking water

22
Q

in the developed world cases of HEV are from what source?

A

eating undercooked pig or deer meat

23
Q

What 2 populations have the highest mortality rate in HEV?

A
  1. underlying chronic liver dz

2. pregnant women

24
Q

What populations get chronic infx (2)

A

solid organ transplant or immunosuppression.

25
Q

Tx fro HEV

A

Ribavarin works. (Category X teratogen. )

26
Q

How are all the different mutations of HCV classified

A

Divided in gentoypes and subgenotypes

27
Q

What does vertical transmission of HEV cuase in fetus

A

Vertical transmission –> fetal hepatitis and death but not birth defects.

28
Q

What is major transmission of HCV

A

IVDA

29
Q

What age group has 2/3 of all cases of chronic HCV

A

people born between 1945 and 1965. 55-75 years old

30
Q

HCV cases are on the increase in what population?

A

the younger 20-29 IVDAs.

31
Q

HCV RNA is only present in what stage of infx

A

acute, chronic (not cleared)

32
Q

HCV Ab is not present in what stage of infx

A

acute (is present in current and chronic)

33
Q

What is HCV txx

A

Peg IFN@2, ribavarin

34
Q

Who is cix in Peg IFN@2 tx? (2)

A

Decompensated hepatic disease or depression

35
Q

What is the MOA of ribavarin

A

Inhibits inosine monophosphate dehydrogenase (IMPDH)-

36
Q

ADE of ribavarinq

A

hemolytic anemia

37
Q

Cix in ribavarin

A

preganat = category X

38
Q

Protease Inhibitors end in ?

A

previr

39
Q

NS5B polymerase inhibitors end in ?

NS5A inhibitors ending in?

A

NS5B = buvir

NS5A = asvir

40
Q

NS5B polymerase inhibitors: MOA?

A

block replication of viral RNA

41
Q

Protease Inhibitor MOA

A

prevents viral polyprotein cleavage and blocks replication of RNA because cannot cleave polyprotein to make active viral polymerase

42
Q

Cannot use protease inhibitors in what condition?

A

decompensated cirrhosis.

43
Q

What is goal of HCV tx?

A

Sustained Virologic Response (SVR)= absence of HCV RNA

44
Q

Who to treat for HCV

A

everyone! too$$$$

D&T test 7- GI (14 decks)

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