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RRPA Clinical Med II > Hepatitis Lecture - Schoeny Exam 3 > Flashcards

Hepatitis Lecture - Schoeny Exam 3 Flashcards

1
Q

Which types of Hepatitis are spread through blood and body fluids? Which are spread through feces?

A

Blood/body fluids: B, C, D

Feces: A, E

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2
Q

Which types of hep cause chronic infection?

A

B, C, D

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3
Q

Which types of hep have a immunization?

A

A, B, D

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4
Q

Symptoms of acute hepatitis?

A

Nausea, vomiting, abd pain, loss of appetite, fever, diarrhea, light (clay) colored stools, dark urine, jaundice

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5
Q

There are 2 lab tests for hep a, hep A IgG, and hep A IgM. What’s the difference?

A

IgG tests for immunity from vaccine or previous infection

IgM tests for acute infection

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6
Q

What vaccines are available for hep A?

A

Havrix for hep A only

Twinrix is hep A/B combo

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7
Q

What is the immunization schedule for Havrix?

A

Children and adolescents - .5mL dose, 2 shot series given 6 months apart
Adults - 1mL dose, 2 shot series given 6 months apart

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8
Q

What is the immunization schedule for twinrix?

A

Standard - 3 shot series given at day 0, 1 month, and 6 months
Accelerated - 4 shot series given at day 0, day 7, day 21, and 1 year.

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9
Q

Hepatitis A treatment?

A

Supportive care

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10
Q

What is the most easily transmissible blood borne pathogen?

A

Hep B

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11
Q

When is the accelerated schedule for twinrix used?

A

For adults who are not immunized.

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12
Q

Can hep B be transmitted through breastmilk?

A

No

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13
Q

Most common hep B modes of transmission?

A

Sexual
Parenteral (needles)
Perinatal

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14
Q

What percentage of Hep B infections clear naturally?

A

80%

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15
Q

When Hep B + mothers give birth, what should be given to the baby at birth?

A

Hep B antibodies and hep b immunization

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16
Q

What patient population has increased risk of poor hep B outcomes?

A

patients of Asian descent

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17
Q

What are the different hepatitis B labs?

A 
HBsAg
Anti-HBs
Anti-HBc
IgM anti-HBC
HBeAg
Anti-HBe
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18
Q

What is HBsAg?

A

Hep B surface antigen.

+ during infection

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19
Q

What is Anti-HBs, what does a + result indicate?

A

Antibody to HBsAg

Indicates immunity to Hep B. Does not specify if it is from infection or immunization.

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20
Q

What is Anti-HBc, what does a + result indicate?

A

Antibody to Hep B core antigen.

+ result indicates prior infection.

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21
Q

What is IgM anti-HBc, what does + result indicate?

A 
IgM class antibodies to Hep B core antigen.
\+ result indicates infection within past 4-6 months.
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22
Q

HBeAg and Anti-HBe are used for what?

A

Specialized hep B treatment

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23
Q

What is the first detectable lab abnormality during hep B infection. When does it become postive?

A

HBsAg - positive 4 weeks after exposure.

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24
Q

Chronic hep B infection would show what lab abnormalities?

A

HBsAg and Anti-HBc would be positive.

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25
An acute hep B infection would show what lab abnormalities?
+ HBsAg, Anti-HBc, and IgM anti-HBc
26
A patient immune to Hep B from immunization would have what + lab(s)?
Anti-HBs
27
What two hep B vaccines are approved in newborns and above?
Engerix and recombivax
28
Immunization schedule for engerix and recombivax?
3 dose series at 0, 1-2, and 4-6 months
29
What Hep B vaccine is a 2 dose series is only approved for ages 18 and up? Immunization schedule?
Heplisav-2 | given at day 0 and 1 month
30
What is the leading cause of liver cancer and liver transplant in the US?
Hep C
31
Is hep C curable?
Yes :)
32
Is hep C vaccine preventable?
No :(
33
Average hep C incubation peroid?
6-7 weeks
34
What are some factors that lead to a worse prognosis in hep C infections?
``` Alcohol intake Age > 40 at time of infection HIV co-infection Male gender Chronic Hep B co-infection ```
35
CDC recommends Hep C testing for people who received clotting factors before 1987 or blood/organs before 1992. Why?
Hep C was not discovered yet, so blood donations could not be screened for it.
36
What labs are used to test for hep C?
Hep C antibody - screening test | HCV PCR - confirmatory test
37
How many genotypes of hep C are there?
6
38
Which hep C genotype is most common in the US?
Genotype 1 (80%)
39
Hep A treatment
Supportive care
40
Hep B treatment
Adefovir, entecavir, or tenofivir
41
There are many hep C treatments. What is "the backbone of what we use today"?
Hep C polymerase inhibitors used with pegylated interferon and ribavirin
42
List some of the Hep C polymerase inhibitors.
Simeprevir | Sofosbovir
43
What test needs to be done prior to treating hep C with zepateir?
Test for NS5A resistance in genotype 1a
44
Most common organism causing infectious esophagitis?
Candida albicans
45
What are common viral causes of infectious esophagitis?
CMV or herpes virus
46
Infectious esophagitis is common in _______ patients
Immunosuppressed
47
Diagnosis of infectious esophagitis is made with ______
endoscopy
48
Treatment for C albicans infectious esophagitis?
Diflucan
49
Treatment for CMV infectious esophagitis?
Ganciclovir *** Only use if you are 100% sure its CMV because ganciclovir is toxic.
50
Treatment for HSV infectious esophagitis?
Acyclovir
51
Name this bacteria: | Gram negative rod residing in mucous gel coating of epithelial cells of the stomach.
H. pylori
52
What conditions are H. pylori associated with?
PUD Gastric adenocarcinoma MALT cell lymphoma
53
What tests are available for H pylori?
Stool antigen Urea Breath test Endoscopy with biopsy
54
Treatment for H. pylori?
Clarithromycin, amoxicillin, and PPI
55
Due to resistance, what substitutions may be made in the typical H pylori treatment?
May substitute either clarithromycin or amoxicillin with doxycycline or metronidazole.
56
What quadrant is the pain from diverticulitis normally?
LLQ
57
Treatment of diverticulitis?
Metronidazole and fluoroquinolone
58
T/F? A botulism infection can be caused by 1 single spore.
true, it is highly virulent
59
Botulism toxin causes descending flaccid paralysis by what mechanism?
Toxin prevents release of ACh at neuromuscular junction
60
What food is often associated with botulism?
Home canned products
61
Does botulism have a rapid or gradual onset?
rapid
62
Treatment of botulism?
ICU admission induce vomiting Antitioxin!!!!! - gotta get it from the CDC
63
What is tinea soleum?
Pork tapeworm
64
What infection that lives in water and migrates to the urinary tract is linked to bladder cancer?
Schistosomiasis hematomium

RRPA Clinical Med II (45 decks)

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