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Microbiology > Hepatitis Viruses > Flashcards

Hepatitis Viruses Flashcards

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1
Q

Types of Hepatitis

A

Viral hepatitis
Alcoholic hepatitis
Non alcoholic steatohepatitis
Autoimmune hepatitis
Neonatal hepatitis

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2
Q

Genome of Hepatitis viruses

A

Only HBV - DNA
Others - RNA

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3
Q

HAV belongs to which family

A

Picornaviridae (Enterovirus 72)

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4
Q

HBV belongs to which family

A

Hepadnaviridae

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5
Q

HCV belongs to which family

A

Flaviviridae

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6
Q

HDV belongs to which family

A

Deltaviridae
Relies on HBV

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7
Q

HEV belongs to which family

A

Caliciviridae Now Herpeviridae

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8
Q

Mode of infection and incubation period of HAV and HEV

A

Feco- oral
IP - 15-50 Days

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9
Q

Mode of infection and incubation period in HBV

A

IP - 50-150 days
Mode - Parenteral, Sexual, Vertical

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10
Q

Mode of Transmission and incubation period of HCV

A

IP - 15-150 Days
Transmission - Parenteral, iv Blood transfusion

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11
Q

Which Hepatitis viruses are enveloped

A

HBV
HCV
HDV

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12
Q

Which Hepatitis virus is cultivable

A

HAV

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13
Q

Vaccines available against which hepatitis viruses

A

HAV
HBV
HEV

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14
Q

Which hepatitis virus is most common cause of Fulminant hepatitis

A

HDV - 5-20%
HAV - 0.1%

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15
Q

Which hepatitis is most common cause of Fulminant hepatitis in Pregnancy

A

HEV - 25%

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16
Q

Which hepatitis virus infection leads to Chronicity

A

HBV and HCV

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17
Q

Hepatitis G affects

A

Doesn’t cause human infection
Affects monocular cells
Route of transmission - blood transfusion
Can protects against HIV

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18
Q

Sizes of Hepatitis viruses

A

Hepatitis A - 27nm
Hepatitis B - 42nm
Hepatitis C - 60nm
Hepatitis E - 30nm

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19
Q

Genotypes and Serotypes of HAV

A

Serotype 1
Genotypes - 6, In humans, 1,2,3

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20
Q

Which genotype of HAV is M/C in world and in India

A

In world - Type 1
In India - 3

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21
Q

HAV is susceptible to

A

Boiling, chlorine, autoclave, Formalin

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22
Q

Clinical features of HAV

A

Fever, anorexia
Nausea/Vomiting
Jaundice
Dark urine
Pale feces

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23
Q

HAV Shedding in stools can be seen for how long

A

2 weeks prior to 2 weeks after symptoms onset

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24
Q

When IgM and IgG appears in case of HAV infection

A

IgM appears with onset of Jaundice
2-4 weeks later IgG seen

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25
Q

When IgM appears in case of HAV infection

A

IgM appears with onset of Jaundice

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26
Q

On Liver biopsy, Hepatitis A and Hepatitis E shows

A

Hepatitis A - Shows increase in Plasma cells
Hepatitis E - Shows Cholestasis (Bile plugs)

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27
Q

Vaccines against Hepatitis A

A

Formaldehyde inactivated vaccine im
Live attenuated vaccine

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28
Q

Formaldehyde inactivated vaccine for HAV given after age of and doses

A

More than 12 months
2 doses apart 6 months gap

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29
Q

Strains of Live attenuated vaccine

A

OH2
And OLA1 Strain

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30
Q

For postexposure prophylaxis of HAV

A

Immunoglobulins - within <2 weeks of exposure
Protection for 1-3 months

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31
Q

Vaccine against HEV

A

Recombinant capsid protein (China)

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32
Q

Genotypes of HBV

A

8 genotypes (A to H)

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33
Q

Serotypes of HBV

A

aYw
adr

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34
Q

Which genotype of HBV is most prevalent in India

A

D genotype

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35
Q

HBV is double stranded or single stranded DNA virus

A

HBV - Partial dsDNA virus - 2 linear strands of DNA - 1) Complete strand or minus strand 2) Incomplete or Plus strand

36
Q

All DNA Viruses are have dsDNA except

A

ssDNA - Parvovirus
Partial dsDNA - HBV

37
Q

Antigen present in HBV Viruses

A

P antigen - Largest, DNA polymerase, Reverse transcriptase, RNAase
C - Core Antigen
S- Surface antigen (HBSAg) - S,M,L
X - HbX - carcinogenesis

38
Q

Which antigen is also known as Australia antigen

A

S - Surface antigen (HBSAg)

39
Q

Which antigen is also known as Australia antigen

A

S - Surface antigen (HBSAg)

40
Q

Which Antigen of HBV is responsible for carcinogenesis

A

X - HbX - carcinogenesis - HCC

41
Q

Infectious particles of HBV

A

Spherical particles - 42nm
Full virions - DANE particles
Genome +, Infection +

42
Q

Non infections particles of HBV

A

Spheres/tubular
Filaments
Genome - , Infection -

43
Q

Mode of infection of HBV

A

Blood products
Sexual intercourse
Percutaneous
Mother to child
Needle stick injury (HBV-30%)

44
Q

Pathogenesis of HBV

A

HBV virion entry - endocytosis - Uncoating (partial dsDNA) - cccDNA (Covalently closed Circular DNA) - then converted to complete DNA - Converted to pgRNA via translation - PgRNA is converted to Minus strand DNA with the help of Reverse transcriptase - Then minus strand DNA converted to Plus strand with the help of DNA Polymerase - Assemble in ER - Release

45
Q

1st virological marker of HBV in blood

A

HBV DNA

46
Q

1st antigen to appear in case of HBV and when it appears and disappears

A

HBsAg - onset of infectivity
Appears 2-6 weeks before onset of symptoms
Disappears 1-2 month after onset of jaundice

47
Q

Epidemiological marker of HBV

A

Anti HBs - comes after gap

48
Q

When HBeAg appears and what it indicates

A

Appears shortly after HBsAg
Indicate active infections and high infectivity

49
Q

AntiHBe indicates

A

It indicates decrease in infectivity

50
Q

Core Ag/HBcAg and AntiHBc antibodies

A

Not detected in blood
AntiHbc antibody - IgM (Marker of window period) and IgG

51
Q

Interpretation of lab diagnosis findings in case of Acute Hepatitis B - high infectivity

A

HBsAg +
Anti HBs -
Anti HBc - IgM
HBeAg +
Anti HBe -

52
Q

Interpretation of lab diagnosis markers in Chronic Hepatitis B - High infectivity

A

HBsAg +
Anti HBs -
Anti HBc - IgG
HBeAg +

53
Q

Interpretation of lab diagnosis markers in HBV Recovery phase

A

Antibodies +ve
Anti HBs +
Anti HBc - IgM + IgG
Anti HBe +

54
Q

Lab diagnosis findings in case of HBV vaccination/immunity

A

Anti HBs +ve

55
Q

Lab diagnosis finding in case of HBV window period

A

Anti HBc IgM +ve

56
Q

How much risk of transmission of HBV to baby if mother is HBeAg +ve

A

90% risk of transmission

57
Q

Risk of transmission of HBV to baby if mother is HBe antibody +ve

A

10-15% risk of transmission

58
Q

Prophylaxis of neonate born to HBV +ve mother

A

One arm immunoglobulins
Other arm HB vaccine (0,1,6 months)

59
Q

Hepatitis B vaccine and it’s schedule

A

Prepared in Yeastv(Saccharomyces cerevicae)
Recombinant killed vaccine
Schedule - 0,1, 6 months

60
Q

Prophylaxis of HBV in case of Needle stick injury in unvaccinated healthcare worker on basis of different sources

A

If HBsAg +ve : Ig + 0,1,6 vaccine
If HBsAg -ve : 0.1,6 vaccine
If Source unknown: 0,1,6 vaccine

61
Q

Prophylaxis of HBV in case of Needle stick injury in vaccinated and responder healthcare worker on basis of different sources

A

Responder - Anti HBs >10IU/ml
No Prophylaxis needed

62
Q

Prophylaxis of HBV in case of Needle stick injury in vaccinated and non responder healthcare worker on basis of different sources

A

Non responder - Anti HBs <10IU/ml
If HBsAg + : Ig + 0,1,6 vaccine
No Prophylaxis if HBsAg -ve or if source unknown

63
Q

Carriers of HBV are classified into

A

If HBsAg +ve beyond 6 months
Simple carriers
Super carriers

64
Q

HBV simple carriers Lab findings

A

HBsAg +ve
HBeAg -ve
Low DNA Polymerase

65
Q

HBV Super carriers lab findings

A

HBsAg +ve
HBeAg +ve
High DNA Polymerase
Increased liver enzymes

66
Q

Escape mutants means

A

No HBsAg, So anti HBs antibodies will not able to neutralize the escape mutant

67
Q

Most common cause of Fulminant hepatitis

A

Hepatitis D

68
Q

HDV Coinfection means

A

HBV + HDV infection together
In Iv drug users mostly leads to Fulminancy

69
Q

HDV Superinfection means

A

Patient is already infected with HBV gets Superadded infection with HDV
Causes fulminant hepatitis

70
Q

Which hepatitis virus is highly mutable and it’s most mutable protein

A

Hepatitis C
Most mutable protein - E2

71
Q

Lab diagnosis findings of HCV

A

IgM HCV
Hep C Tridot testing
HCV RNA PCR - Diagnosis of choice

72
Q

Morphological changes in Acute hepatitis

A

Bodies - Councilman bodies (Hep.C)
Spotty necrosis - Dropout necrosis
Kupffer cell hyperplasia (Macrophages)

73
Q

Morphological changes of Chronic hepatitis

A

Ito/Stellate cells - Fibrosis

74
Q

Histological finding of Hepatitis B infection

A

Ground glass hepatocyte (diffusely pink cells) - contains surface antigen in ER

75
Q

Histological findings in case of Hepatitis C

A

Macrovascular steatosis (fatty changes)
Lymphoid follicles (prominent)

76
Q

Histological findings of Hepatitis D infection

A

Microvascular steatosis

77
Q

Most common cause of Sporadic Acute hepatitis in India

A

Hepatitis E

78
Q

Most common of Fulminant viral hepatitis

A

HDV

79
Q

Most common cause of Fulminant viral hepatitis in Pregnancy

A

HEV

80
Q

Most common cause of transfusion related hepatitis

A

HBV

81
Q

Most common cause of Chronic hepatitis

A

HBV

82
Q

Which hepatitis virus have Maximum risk of potential of chronicity

A

HCV

83
Q

Most common cause of carrier state

A

HBV

84
Q

Most common cause of viral Hepatocellular carcinoma

A

HBV

85
Q

Which hepatitis virus have strong association with Hepatocellular carcinoma

A

HCV

86
Q

Extra hepatic manifestations of Hepatitis B

A

Polyarteritis Nodosa
Membranous glomerulopathy

87
Q

Extra hepatic manifestations of Hepatitis C

A

Mixed Cryoglobulinemia (M/C)
Lichen planus
MPGN

Microbiology (37 decks)

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