High-Yield Concepts in Viral Hepatitis (Gastrointestinal Diseases)

Question 1

Only human Hepatitis Virus that is a DNA Virus

Answer 1

Hepatitis B (others are RNA viruses)

Question 2

HBV Serology: First detectable marker

Answer 2

HBs Antigen (HBsAg)

Question 3

HBV Serology: Qualitative marker for high infectivity/replication

Answer 3

HBe Antigen (HBeAg, disappearance is a harbinger of clinical improvement & resolution of infection)

Question 4

HBV Serology: Quantitative marker for high infectivity/replication

Answer 4

HBV/DNA (also correlates with level of liver injury)

Question 5

HBV Serology: First antibody to rise

Answer 5

Anti-HBc antibody (1-2 weeks after HBsAg)

Question 6

HBV Serology: Positive during window period

Answer 6

IgM anti-HBc antibody

Question 7

HBV Serology: Protective antibody and the only marker to appear after immunization

Answer 7

Anti-HBs antibody

Question 8

HBV Serology: Criteria for chronic HBV infection

Answer 8

HBsAg remains detectable beyond 6 months

Question 9

Nonpercutaneous routes of HBV transmission with the greatest impact

Answer 9

Intimate (especially sexual) contact

Perinatal transmission

Question 10

Most important mode of HBV perpetuation in the Far East and Developing countries

Answer 10

Perinatal transmission (particularly at time of delivery; not related to breastfeeding)

Question 11

Most important risk factor for progression to Cirrhosis and HCCA in Hepatitis B

Answer 11

Level of HBV replication

Question 12

Most frequent indication for liver transplantation

Answer 12

Hepatitis C

Question 13

Most common symptom in Hepatitis C

Answer 13

Fatigue (jaundice is rare)

Question 14

Most common risk factor for Hepatitis C

Answer 14

Injection Drug Use

Question 15

The most common genotype of Hepatitis C worldwide

Answer 15

Genotype 1

Question 16

Gold standard for establishing a diagnosis of Hepatitis C (most sensitive indicator)

Answer 16

HCV RNA

Question 17

Best prognostic indicator in chronic Hepatitis C

Answer 17

Liver Histology

Question 18

Defective RNA Virus that coinfects with and requires helper function of HBV

Answer 18

Hepatitis D (HDV)

Question 19

Distinguishing serologic feature of chronic Hepatitis D

Answer 19

Presence of antibodies to liver-kidney microsomes (anti-LKM3)

Question 20

Most common cause of acute Hepatitis in India, Asia, Africa, and Central America

Answer 20

Hepatitis E

Question 21

Most feared complication of Viral Hepatitis

Answer 21

Fulminant hepatitis (massive hepatic necrosis)

Question 22

Acute Yellow Atrophy

Answer 22

The striking postmortem finding in massive hepatic necrosis, referring to a smalll, shrunken, soft liver

Question 23

First approved therapy for chronic Hepatitis B

Answer 23

IFN-alpha (although no longer used for treatment)

Question 24

First nucleoside analogue to be approved for Hepatitis B

Answer 24

Lamivudine

Question 25

Most potent of the HBV antivirals

Answer 25

Entecavir

Question 26

First-line drugs for Hepatitis B

Answer 26

PEG-IFN, entecavir, or tenofovir

Question 27

Best treatment regimen for chronic Hepatitis C

Answer 27

PEG-IFN + ribavirin
24 weeks for genotypes 2 and 3
48 weeks for genotype 1

Question 28

Most pronounced side effect of Ribavirin

Answer 28

Hemolysis

Question 29

Single most important clinical variable determining IFN responsiveness in hepatitis C

Answer 29

Duration of infection