ID 13

Question 1

HBV transmission mnemonic

Answer 1

Parenteral (blood)
sexual (baby-making)
perinatal (birthing)

Question 2

HDV transmission

Answer 2

same as HBV

Question 3

most common HEV source

Answer 3

waterborne

Question 4

incubation
HAV -
HBV -
HCV -
HDV - 
HEV -

Answer 4

HAV - short (weeks)
HBV - long (months)
HCV - long
HDV - superinfection - short, confection = long
HEV - short

Question 5

HDV superinfection

Answer 5

HDV after HBV

Question 6

HDV coinfection

Answer 6

HDV with HBV

Question 7

HAV clinical course

Answer 7

Asymptomatic (usually)

Acute

Question 8

HV clinical course

Answer 8

Initially like serum sickness (fever, arthralgia, rash); may progress to carcinoma.

Question 9

HDV clinical course?

Answer 9

similar to HBV

Question 10

HEV clinical course

Answer 10

fulminant hepatitis in pregnant women

Question 11

HBV prognosis

Answer 11

Most adults have full resolution; minority have chronic infection.

Question 12

HDV prognosis?

Answer 12

Superinfection –> worse prognosis

Question 13

HCV prognosis?

Answer 13

majority develop stable, Chronic hep C

Question 14

HAV liver biopsy

Answer 14

1) hepatocyte swelling
2) monocyte infiltration
3) councilman bodies

Question 15

HBV liver biopsy

Answer 15

granular eosinophilic “ground glass” appearance.

Question 16

HCV liver biopsy

Answer 16

lymphoid aggregates with focal areas of macro vesicular steatosis

Question 17

HDV liver biopsy

Answer 17

similar to HBV

Question 18

HEV liver biopsy

Answer 18

patchy necrosis

Question 19

carrier state with hepatitis?

Answer 19

only seen with HBV and HCV

Question 20

anti-HAV (IgG) significane

Answer 20

IgG antibody indicates prior HAV infection and/or prior vaccination.
*protects against reinfection.

Question 21

HBsAg indicates…

Answer 21

infection

Question 22

Anti-HBs indicates…

Answer 22

immunity

Question 23

Significance of Anti-HBc

Answer 23

If IgM = acute/recent infection.

If IgG = prior exposure or chronic infection

Question 24

marker of infection during window period?

Answer 24

1) Anti-HBe

2) IgM anti-HBc (may be sole positive marker of infection during window period).

Question 25

What is HBeAg

Answer 25

Secreted by infected hepatocyte into circulation. Not part of mature HBV virion.

Question 26

Significance of Anti-HBe

Answer 26

low transmissibility

Question 27

Marker during incubation period?

Answer 27

HBsAg

Question 28

Other marker of alcohol use?

Answer 28

ethyl glucuronide

Question 29

Markers of prodrome, acute disease

Answer 29

HBsAg IgM anti-HBc HBeAg

Question 30

Markers of Chronic high infectivity HBV?

Answer 30

HBsAg HBeAg IgG anti-HBc

Question 31

Markers of Chronic low infectivity HBV?

Answer 31

HBsAg Anti-HBe Anti-HBc IgG

Question 32

markers during recovery?

Answer 32

Anti-HBs Anti-HBe Anti-HBc IgG

Question 33

markers of immunity?

Answer 33

anti-HBs

Question 34

HIV envelope proteins?

Answer 34

gp120 | gp41

Question 35

gp120?

Answer 35

docking glycoprotein. attaches to host CD4+ cell

Question 36

gp41?

Answer 36

transmembrane glycoprotein. fusion and entry

Question 37

p17?

Answer 37

HIV matrix protein

Question 38

p24?

Answer 38

HIV capsid protein

Question 39

origin of gp120 and gp41?

Answer 39

Formed from cleavage of gp160 to form envelope glycoproteins.

Question 40

what is gag?

Answer 40

codes for p24 + p17

Question 41

what is pol?

Answer 41

gene that codes for reverse transcriptase + aspartate protease + integrase

Question 42

virus binding mechanism

Answer 42

Binds CD4 + coreceptor (either CCR5 on macrophages in early infection or CXCR4 on T cells in late infection).

Question 43

heterozygous CCR5 mutation?

Answer 43

slower course

Question 44

homozygous CCR5 mutation?

Answer 44

immunity

Question 45

ELISA characteristics

Answer 45

sensitive, high false positive rate and low threshold. RULE OUT.

Question 46

Western blot characteristics for HIV

Answer 46

Specific, low false positive rate and high threshold. RULE IN.

Question 47

AIDS diagnosis

Answer 47

1) CD4 below 200 2) HIV positive with AIDS-defining condition 30 CD4+ percentage lower than 14%

Question 48

problem with ELISA/Western blot

Answer 48

Often falsely negative in first 1-2 months of HIV infection and falsely positive initially in babies born to infected mothers (anti-gp120 crosses placenta).

Question 49

What is the window period?

Answer 49

Time between acute infection and recovery.

Question 50

How can you tell AIDS stage based on surface proteins?

Answer 50

as patients enter the symptomatic period and as immune function declines, peoples’ ability to produce any isotype of antibody declines and thus antibodies to capsid antigen (p24) will decline (can’t class switch due to TH deficiency). Once patients develop AIDS in the final stages of the disease, they’re so deficient in T cells that they can’t undergo class switching. IgM can be made in the absence of TH cells, however, and production of IgM continues against envelope glycoproteins (gp120 and gp41) since those antigens are constantly being altered by the process of random mutation (genetic drift).

Question 51

AIDS virus type

Answer 51

lentivirus (long latent period)

Question 52

What is reverse transcriptase?

Answer 52

An RNA-dependent DNA polymerase because it synthesizes cDNA from an RNA template.