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Immunology and Microbiology > Hepatitis (Exam 2) > Flashcards

Hepatitis (Exam 2) Flashcards

1
Q

Hepatitis

A

Inflammation of the liver

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2
Q

Two types of hepatitis

A

Acute (<6 months)
chronic (>6 months)

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3
Q

Causes of Hepatitis

A

VIRUSES
drug toxicity
alcohol
autoimmune diseases
bacteria
parasites

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4
Q

Symptoms of Hepatitis

A

Swelling of liver
Jaundice
dark urine
Transaminase- alkaline phosphate levels increased

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5
Q

Symptoms of Viral Hepatitis

A

Yellowing skin and eyes, dark urine, loss of appetite, fatigue

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6
Q

Compensated Cirrhosis

A

Liver can still function, no signs or symptoms

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7
Q

Decompensated Cirrhosis

A

Liver is too damaged to function normally, symptoms such as jaundice and ascites are present

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8
Q

Progression of Hepatitis

A

Normal liver –> chronic hepatitis –> hepatitis with fibrosis –> bridging fibrosis –> cirrhosis with hepatocellular carcinoma

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9
Q

Which hepatitis have a vaccine?

A

Hepatitis A and B
No vaccine for Hepatitis C (good luck)

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10
Q

Which hepatitis cause liver cancer?

A

Hepatitis B and C

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11
Q

How long does Hepatitis A last?

A

Few weeks to several months (2 months), most recover with no lasting liver damage, very rare but death can occur

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12
Q

How long does Hepatitis B last?

A

Few weeks to serious, life-long condition with individuals developing chronic liver disease - cirrhosis, failure, cancer

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13
Q

How long does Hepatitis C last?

A

Few weeks to serious, life-long condition
Most develop chronic hepatitis C
5%-25% with ^ will develop cirrhosis over 10-20 years

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14
Q

Unimmunized infants who get infected by hepatitis B

A

Develop chronic INFECTION

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15
Q

Older children and adults who get infected by hepatitis B

A

Develop chronic hepatitis B

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16
Q

How is Hepatitis A spread?

A

Ingesting fecal matter from contaminated sources/people
Food, drinks including ice, blood, stool, direct sex contact, poor sanitation

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17
Q

How is Hepatitis B spread?

A

Blood, semen, bodily fluids from infected person enter body of uninfected, sex, sharing of personal items, needles. can also be transmitted from birth to an infected mother

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18
Q

How is Hepatitis C spread?

A

Blood from infected person enters body of someone uninfected

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19
Q

Global mortality from viral hepatitis is…

A

INCREASING o_o

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20
Q

HAV virus

A

ssRNA
No envelope - Capsid
Picorna/hepatovirus
Fecal-oral
Not chronic
heat and acid stable
high prevalance/contagious

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21
Q

HBV virus

A

dsDNA
Envelope
Hepadnaviridae
Parenteral
Chronic

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22
Q

HCV virus

A

ssRNA
Envelope
Parenteral
Flaviviridae + Hepacivirus
Chronic

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23
Q

HDV virus

A

ssRNA
Envelope
Parenteral
Delta virus

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24
Q

HEV virus

A

ssRNA
No envelope - Capsid
Waterborne, animals
Togavirus and alpha virus-like
Chronic - immunocompromised

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25
who is at risk for HAV?
close contacts of HAV-infected individuals, recreational drug users, travelers to endemic areas, homeless individuals, MSM
26
prevention of HAV
vaccination - HepA (inactivated/killed vaccine) post-exposure prophylaxis within 14 days - immune globulin
27
HAV pathogenesis
ingestion replication in oropharynx/GI tract transported to liver sited in bile transported to intestines shed in feces brief viremia cellular immune response-clinical disease and control *uses liver cell for viral replication; interferes with liver function*
28
major site of replication
liver
29
incubation of HAV
15-45 days
30
incubation of HBV
45-160 days
31
incubation of HCV
15-150 days
32
incubation of HDV
30-60 days
33
incubation of HEV
15-60
34
leading cause of liver cancer worldwide from which infection?
Hepatitis B infection - no cure, infants and children most likely to develop this - vaccine preventable
35
HBeAg
HBV e-antigen (expressed when actively replicating)
36
HBsAg
HBV surface antigen
37
HBcAg
HBV core antigen
38
HBV care for adults and children
see liver specialist every 6 months. - physical exam - blood tests for Hep B markes - blood tests for liver enzymes (ALT/AST) - blood tests for liver cancer screening (AFP) - imaging studies of the liver (ultrasound, CT scans, FibroScan)
39
HBV treatments
direct anti0viral medications (nucleoside analogs): - Entecavir - Lamivudine - Adefovir dipivoxil - Telbivudine - Tenofovir alafenamide -Tenofovir Immune boosters: - interferon alpha 2b pegylated interferon
40
who is at risk for Hepatitis A?
close contacts of HAV infected recreational drug users travelers homeless individuals MSM
41
Does HAV cause chronic infections?
NO! infection usually resolves within 2 months
42
HAV is preventable by
vaccination and post exposure prophylaxis
43
HAV pathogenesis
ingestion --> replication in GI tract --> transported to liver --> shed in bile --> transported to intestines --> shed in feces
44
prevention of HAV preexposure? post exposure?
pre - HepA vaccine (inactivated/killed vaccine) post - immune globulin (within 14 days)
45
what part of the virus is used for vaccine?
the surface antigen
46
HBV viral genome
3.2 kb core and surface antigens
47
Hepadnaviral replication
RC-DNA transported to nucleus --> repaired to form cccDNA --> transcription to pgRNA --> pgRNA is encapsidated and reverse transcribed in nucleocapsid
48
Hepatitis B infection is the
leading cause of liver cancer worldwide
49
is there a cure for hepatitis B?
no :(
50
how is hepatitis B transmitted?
parenteral via infected body fluids unprotected sex needle sticks mother to fetus
51
global viral hepatitis B
257m global
52
acute hepB serology
total anti-HBc stays for a long time IgM anti-HBc goes down
53
chronic hepB serology
HBsAg stays around for some time and is larger than total anti-HBc (antibodies)
54
standard recommendation for care to visit a liver specialist is
every six months can be more/less depending on medical situation
55
testing during liver specialist recommendation
physical exam blood tests for hepb markers blood tests for liver enzymes blood tests for liver cancer screening imaging studies of the liver
56
persons who are HBsAg positive should not
not share toothbrushes/razors not share injection equipment not share glucose testing equipment
57
persons who are HBsAg positive should have
household and sexual contacts vaccinated
58
so blood doesn't spread, persons who are HBsAg positive should
cover open cuts and scratches clean blood spills with bleach solution not donate blood, organs or sperm
59
subunit recombinat vaccine
first dose given at birth
60
HEV is transmitted via
fecal oral route, principally via contaminated water
61
what happens if someone is infected with hep B at birth?
progress to chronic HBV infections
62
is there a vaccine for HEV?
yes but it is not approved in the US only in China
63
Treatment for HEV
Ribavirin treatment of severe acute HEV and chronic HEV infections symptomatic treatment
64
HEV infections usually
resolve on their own within 4 to 6 weeks
65
blood donor screening is done for which hepatitis?
hepB and hepC
66
Hepb treatment
interferon (PegIFN)
67
the cure rates for chronic HCV
rising
68
progression of hepatitis C can take
25-30 years
69
serologic pattern of acute HCV infection
anti-HCV is still present even if the virus isn't might not have active virus over time
70
HBV post exposure prophylaxis
anyone who is non-HBV-immune of unknown HBV status should receive prophylaxis and initiation of HBV vaccination WITHIN 24 HOURS of suspected exposure
71
prevalence by risk based of HCV is
MSM long term kidney dialysis healthcare workers exposed children born to HCV infected mothers incarceration recipient of a unsterile tattoo recipients of blood transfusion
72
In the United States, Hepatitis C is
under diagnosed (75%)
73
how much of the world has viral hepatitis C
71m global (1/4 of the amount of hepB)
74
chronic infection of HCV can lead to cirrhosis which leads to
liver failure or hepatocellular carcinoma
75
North America is not really affected by hepC because of
screening in blood banks
76
Hepatitis C virus is associated with
flavivirus (dengue, west nile, yellow fever, zika)
77
heterogeneity of HCV
no proofreading in the polymerase --> mutations --> viral diversity
78
HDV is a
defective virus that consists of a protein capsule surrounding low molecular weight RNA
79
heterogeneity of HCV allows for
escape from host immune system and medications
80
how many genotypes and subtypes of HCV are there?
six major genotypes with over 15 subtypes
81
there are multiple different types of hepC that differ
slightly in the genome
82
HCV life cycle follows
APUMAR
83
HBV-HDV
co-infection getting infected simultaneously with HBV and HDV low risk 5% of chronic infection, severe acute disease
84
HDV superinfection in HBV Carrier
being chronically infected with HBV and contracting HDV usually develop chronic HDV infection high 70-90% chronic liver disease
85
HDV therpahy
none, sucks to be u
86
Lambda mechanism
immune response stimulator
87
Myrcludex B mechanism
entry inhibitor
88
Lonafarnib mechanism
prenylation inhibitor
89
ezetimibe
NTCP inhibitor
90
REP 2139 REP 2165
HBsAg Inhibitor
91
GI- 18000
Immune response stimulator
92
ALN-HDV
RNAi Gene Silencer

Immunology and Microbiology (22 decks)

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