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IHD Part 2 - BDS 3 > hepatitis viruses - Hepatobilary system > Flashcards

hepatitis viruses - Hepatobilary system Flashcards

1
Q

hepatitis

A

general term referring to inflammation of liver

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2
Q

causes

A

1) infectious
- viral
- bacterial
- fungal
- parasitic
2) non infectious
- alcohol
- drugs
- autoimmine
- metabolic

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3
Q

progressions of hepatitis

A

chronic hepatiti
cirrhosis
hepatocellular caricnoma

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4
Q

signs and symptoms of hepatitis

A 
malaise
jaundice
dark urine
pale fatty stools
serum and urine biochemicstru
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5
Q

what is a complete virus called

A

virion

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6
Q

general viral structure

A

strand of nucleic acid DNA/RNA
surrounded by protective protein coat (capsid)
sometimes have lipid membrane (envelope) surrounding the protien

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7
Q

types of hepattis

A 
A
B
C
D
E
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8
Q

how are the types of hepatitis split

A 
how they are spread
A and E
- foetal oral spread
others
- parenteral route (i.e. any route apart from faecal oral)
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9
Q

Hep A

A 
picorna virus
genotypes 1 7
1-3 and 7 human disease
foetal oral spread
2 week incubation 
4-10 day prodrome
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10
Q

prodrome

A

early symptoms

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11
Q

what are their vaccines fro

A

A and B

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12
Q

antibody general reponsce and what do they indicate

A

IgM produced first when host exposed to antigen
then delclines
IgG produced, remains high (IgG indicated part infecion/immunity, IgM indicate acute or primary infections

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13
Q

serology of Hep A

A
  • incubation period at start
  • prodrome phase (early symptoms start)
  • virus detectable before prodrome
  • IgM starts production, then declines
  • IgG after, remains high
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14
Q

Hep B viral structure

A
  • central core with the double stranded DNA, DNA polymerase, Hbc antigen
  • breakdown product of Hbc is Hbe antigen which is found in the serum (marker of active infection)
  • surrounded by envelope
  • produces Hbs Ag (from the surface), shedding from the surface you can get spherical or filament forms, but these are non infective
  • only the whole virion is infective
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15
Q

what is the whole vision of Hep B called

A

dane particle

infecive

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16
Q

what can Hep B develop into

A

25%

1) chronic persistent hepatitis
- ‘healthy carrier’
2) chronic active heptattis

17
Q

Hep B spread

A

parenteral route (vertical, parenteral, sexual)
dsDNA virus
resides and multiples in hepatocytes

18
Q

non infective Hep B

A

filament
spheres
of HBs

19
Q

what does the DNA of hep B code fro

A

4 genes

1) S
- codes for surface antigen
2) C
- core protien
3) P
- polymerase
4) X
- regulatory in terms of viral replication

20
Q

HBc gene and transcription

A

HBc gene split into two
- pre C
- core gene
When transcribed there is a signal peptide at the start, which is modified by protease
- either cuts the signal peptide fully off or partially off
- if some pre C left peptide left, forms Hbe antigen (secreted and can be found in serum)
- if fully cut off, C antigen produced (not secreted)

21
Q

seriology of acute Hep B infection / lab detection

A

Focused on detection of Hep B surface antigen (HBs Ag) - first produced in repsonce
- acute HBV infection characterised by presence of HBs Ag and IgM to the core antigen HBc
Initial phase of infection
- pts seropositive for Hep Be antigen
- usually marker of high levels of replication of the virus
- Presence of HbeAg indicates blood/fluids of individual are highly contagious

22
Q

serology of chronic Hep B infection and what is the marker indicating

A
  • persistence of HBsAg for at least 6 months (with/without HBeAg) as HBs remained elevated
  • persistence of HBsAg is principle marker for developing chronic liver disease and liver cancer (hepatocellular carcinoma) later in life
23
Q

percentage of chronic infection progressing to chronic liver disease hep c

A

10

24
Q

hep D

A

caused by defective RNA virus
- has to co exist with HBV
- small virus
- outer coat derived from HBs Ag, cannot survivie without HBV
ie Those with Hep B can be Hep D positive

25
Q

hep D virus

A

RNA virus

  • delta antigen surroudsn the RNA
  • delta antigen is looked for in sero diagnosis
  • coat derived from Hep B surface antigen
26
Q

hep C viral structure

A

small enveloped single stranded RNA virus (SSRNA)

  • core of genetic material surrounded by icosahedral capsid
  • lipid envelope
  • inside the envolope is two glycoproteins, E1 and E2 (help the virus bind to host cells)
  • complex genome, 10 genes transcribed as one long protein which is then cut into 10 different proteins
  • E2 is responsible for attachment to host cells via scavenger receptors B1 and CD81
27
Q

hep C progression

A 
50-85% become chronic
-	50% fatigue
-	25% cirrhosis
-	5% HCC (carcinoma)
Persistence
-	low replication rate
-	variants selected by non reactivity with Ab
28
Q

treatment of Hep C

A

interferon A + ribavirin

29
Q

hep E

A

RNA herpesvirus
4 genotypes
foetal oral spread

30
Q

diagnoiss of Hep E

A

PCR

serum IgM/IgG Abs

31
Q

vaccines for d?

A

No specific vaccine for D as you can only get it with B, if vaccinated for B will not get D

IHD Part 2 - BDS 3 (55 decks)

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