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Ex3GI CM > Hepatitis & Misc GI- Schoenwald > Flashcards

Hepatitis & Misc GI- Schoenwald Flashcards

1
Q

Which types of hepatits are feces derived and which types are blood/bodily fluid derived?

A

Feces- A, E

Blood- B, C, D

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2
Q

How are hep A & E spread?

A

fecal to oral

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3
Q

Which hep types cause chronic infection that the body never clears? (meaning they will stay with you forever)

A

Hep B, C, D

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4
Q

Which types of hepatitis can be prevented with immunization but there are still a high incidence of?

A

A & B

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5
Q

All hepatitis causes the same _______

A

symptoms

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6
Q

What are the symptoms of hepatitis?

A
  • N/V
  • Abdominal pain
  • Loss of appetite
  • Fever
  • Diarrhea
  • Light (clay) colored stools
  • Dark urine
  • Jaundice
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7
Q

Where is the highest prevalence of Hep A in the world?

A

Mexico, central america, africa

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8
Q

What is Hep A IgG?

A

+ if youv’e ever had the infection or have immunity from the vaccine

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9
Q

What is Hep A IgM?

A

Right meow

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10
Q

The hep A vaccine is approved in people ____ months and older and is called _____

A

12, Harvix

It is a childhood recommended vaccine

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11
Q

Hep A/B combo (Twinrix) is NOT recommended for who?

A

Childhood, only recommended in 18+ years

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12
Q

What is prophylaxis for Hep A?

A

Hep A vaccine

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13
Q

What is the tx for Hep A?

A

Supportive- no tx

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14
Q

Hep ____ is the most easily transmissible of all blood borne pathogens and more preventable and infectious than HIV

A

Hep B

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15
Q

How do you prevent Hep B?

A

Hep B vaccine

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16
Q

There is a high concentration of Hep B in these three things?

A
  • Blood
  • Serum
  • Wound exudates

*commonly spread also by semen, vag fluid and saliva (moderate concentration)

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17
Q

What are three modes of transmission of Hep B?

A
  • sexual
  • parenteral
  • perinatal (birth)
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18
Q

Does Hep B resolve on its own?

A

Yes, 80% will

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19
Q

This viral hepatitis serologic marker is the Hep B surface antigen which means you have an acute/chronic infection?

A

HBsAg

Hep B surface antigen

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20
Q

This viral hepatitis serologic marker indicates past infection with immunity or immune response from the vaccine?

A

Anti-HBs

Antibody to HBsAg

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21
Q

This viral hepatitis serologic marker is how we tell if a person is + from infection or from an immunization

A

HBcAg

Hep B core antigen

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22
Q

In an acute infx, HBsAg will be + how many weeks after infection, peak at this # of weeks and be - at this week?

A

Show up 3-4 wks after initial infection, peak at 12 weeks and - at 24 weeks

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23
Q

An acute Hep B infection (IgM anti-HBc) will be + at what week, peak at what week and be - at what week?

A

Show up at 6 weeks, peak at 16 weeks and disappear at 32 weeks

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24
Q

Total anti-HBc in acute infection starts at what week, peaks at what week and when what happens?

A

+ around 6 weeks, peak at 20 weeks and stays +

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25
Q

______is generally interpreted as indicating recovery and immunity from hepatitis B virus infection

A

Anti-HBs

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26
Q

Anti-HBs is + after how many weeks, peaks at x weeks and then what happens?

A

+ at 32 weeks, peaks at 40ish weeks and stays + over time

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27
Q

The 20% that do not clear the Hep B virus progress to ______ infection

A

Chronic

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28
Q

Acute Hep B is the first x months then chronic is what?

A

First 6 months then chronic is years

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29
Q

In a chronic infection, HBsAg will peak at what and then what? where as it will be negative at 24 weeks in acute infection

A

It will be positive at week 2 and then peak at week 10 then stay positive

30
Q

IgM is only present in the first _____ weeks of infection

A

36

31
Q

You follow _____ to see viral DNA levels throughout the process of Hep B?

A

DNA

32
Q

What is the interp & Action of these values?

HbsAg: neg
anti-HBc: neg
anti-HBs: neg

A

interp: susceptible to HBV
action: vaccinate

33
Q

What is the interp & Action of these values?

HbsAg: neg
anti-HBc: neg
anti-HBs: pos

A

interp: Immunne due to vaccination
action: nothing

34
Q

What is the interp & Action of these values?

HbsAg: neg
anti-HBc: pos
anti-HBs: pos

A

interp: Immune due to infection
action: counsel & treat as clinically indicated

35
Q

What is the interp & Action of these values?

HbsAg: pos
anti-HBc: pos
IgM/anti-HBc: pos
anti-HBs: neg

A

interp: acute HBV infection
action: report and counsel

36
Q

What is the interp & Action of these values?

HbsAg: pos
anti-HBc: pos
IgM/anti-HBc: neg
anti-HBs: neg

A

interp: chronic HBV infx
action: report & counsel

37
Q

What is the Hep B vaccine called?

A

Engerix & Recombivax

38
Q

Is hep B a routine infant vaccination?

A

Yes

39
Q

Who is eligible for the Hep B vaccination?

A
  • routine infant
  • ages 11-15 “catch up” and through age 18
  • over 18 high risk
40
Q

This type of hepatitis is 5x more widespread than HIV, it is the leading cause of liver cancer and liver transplantation in the US and has no vaccine available. Risk for infection after needle stick is 2%

A

Hep C

41
Q

This type of hepatitis is from injection drug use, transfusions and exposure to blood

A

Hep C

42
Q

How do we test for Hep C?

A

-Test for the Hep C antibody and if they have it, confirm with PCR

43
Q

20% of Hep ____ will clear on its own as compared to 80% clearance with Hep ___

A

Hep C, Hep B

44
Q

Who should be routinely screened for HCV?

A

Based on increased risk for infection

  • Ever injected illegal drugs
  • recieved clotthing factors made before 1987
  • received blood/organs before 1995
  • ever on chronic hemodialysis
  • evidence of liver disease
  • healthcare workers
  • children born to HCV positive women
45
Q

Treatment for HAV

A

supportive

46
Q

Treatment for HBV

A

difficult (“Virs”)

Adefovir, entecavir, tenofivir

47
Q

Treatment for HCV

A
  • pegylated interferon

- ribaviron

48
Q

Name of HCV drugs?

A
  • simeprevir

- Sofosbovir

49
Q

What is a good combo HCV drug?

A

Harvoni- Sofosbovir/Ledipasvir

50
Q

This HCV drug can be used in cirrhosis and have a 90% cure rate

A

Epclusa- sofosbuvir/velpatasvir

51
Q

All hepatitis meds are contraindicated with _________ and there is also a risk of Hep ____ reactivation

A

amioderone, Hep B

52
Q

What is the mc cause of infectious esophagitis?

A

candida albicans

-also CMV and HSV

53
Q

Infectious esophagitis is common in which patient population?

A

Immunosuppressed, HIV/DM

54
Q

Patients with infectious esophagitis can have dysphagia, odynophagia, and retrosternal CP that can mimic an ______

A

MI

55
Q

How to dx infectious esophagitis?

A

endoscopy

56
Q

How to tx infectious esophagitis caused by candida?

A

diflucan

*if pt can’t swallow, may need IV diflucan

57
Q

How to tx infectious esophagitis caused by CMV?

A

ganciclovir (comes in IV and is more toxic

58
Q

How to tx infectious esophagitis caused by HSV?

A

acycolvir

59
Q

This bug has a direct correlation with peptic ulcer disease?

A

H. pylori

60
Q

This bug is associated with MALT cell lymphoma

A

H. pylori

61
Q

How to dx H. pylori?

A

Stool Ag, urea breath tests, endoscopy/bx

62
Q

How to treat H.pylori?

A

combo of PPI & clarithromycin and amoxicillin

63
Q

This causes LLQ pain tenderness, bloody stools and fever

A

Diverticulitis

64
Q

How to tx diverticulitis?

A

combo of metronidazole and fluoroquinolones (cipro and metronidazole)

65
Q

Botulism produces ______ that prevent release of Ach at neuro-muscular junction

A

toxins

66
Q

Flaccid and descending paralysis are from what disease?

A

Botulism

67
Q

Is botulism symmertric of asymmetric impairment of cranial nerves?

A

symmetric

68
Q

Double vision is often the first presentation of this disease?

A

Botulism

69
Q

These are signs of what disease?

  • Ophthalmoplegia and ptosis of eyelids
  • Decreased gag reflex
  • Facial weakness with normal mental status
  • Descending paralysis
A

Botulism

70
Q

What is the mainstay treatment for botulism?

A

Antitoxin

71
Q

This is a pork tapeworm and the cause of neurocister sarcosis?

A

Teneia soleum

72
Q

This type of parasitic infection can get into the bladder and cause problems with urinary tract

A

schistomyosis infection

Schistomyaisis hematobium = causes bloody urine and bladder CA

schistomyasis manceni and becobium are not correlated with bladder CA

Ex3GI CM (15 decks)

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