IDIS GI Infections Flashcards
Infectious esophagitis is associated with ____ and ____. What are the 3 main etiologies?
dysphagia and odynophagia
GERD, infections, medications
Infectious causes of esophagitis are:
What is most common?
- candida albicans (most common)
- CMV
- HSV
- HIV
- VZV
What is unique to esophagitis?
odynophagia
What is key with esophagitis caused by HSV?
abrupt onset
What is key with esophagitis caused by CMV?
gradual onset of Sx
only occurs in IC hosts
What is the most common cause of chronic active gastritis and peptic ulcer disease?
Helicobacter pylori
Often asymptomatic, pain or discomfort in pit of stomach, pain in LUQ, pain from belly to back, burning gnawing sore vague discomfort, belching without relief, N/V
Dx?
chronic active gastritis
Gnawing or burning epigastric pain, bleeding that results in anemia weakness or fatigue, hematemesis melena or hematochezia, gastric or duodenal ulcers
Dx?
peptic ulcer disease
Pain is made worse by eating in ___ ulcers, but better with eating or taking antacids in ___ ulcers.
gastric ulcers- worse
duodenal ulcers- better
Most common cause of esophagitis?
- HSV
- CMV
- HIV
- Candida albicans
- Streptococcus pyogenes
Candida albicans
60 y/o, epigastric pain, hurts most in morning and 2hr after eating, melena noted. Ulcer noted in duodenum on EGD. Most likely diagnosis?
- Esophagitis
- Gastritis
- Peptic ulcer disease
- Hepatitis
Peptic ulcer disease
Which hepatitis would need a history of travel?
HEV- 20% mortality rate in pregnant women
Which hepatitis has a chronic carrier state?
HBV and HCV have chronic carrier states
HAV and HEV do NOT
____ has a mortality rate 10 times that of ____.
HEV, HAV
Eating raw or undercooked shellfish, daycare facilities, areas with poor sanitation practices, travel to developing countries, MSM, healthcare institutions, food service, illicit drug users
HAV
EIA for IgM and IgG for ____.
- Positive for IgM = _______ infection
- Positive for IgG = _______ infection
HAV
acute HAV- IgM
previous HAV- IgG
Chronic hepatitis: ___ is more likely to be asymptomatic compared to ___.
HCV, HBV
Fulminant hepatitis occurs in ____ of patients.
1%
HCV has __ to __% of chronic cases compared to HBV having __ to __%
HCV 70-85%
HBV 5-10%
Primary hepatocellular carcinoma: ___ is associated with 80% of the cases of liver carcinoma.
HBV
Most common route for transmission of HBV?
sexual contact
Most common route for transmission of HCV?
percutaneous routes: injection of drug use (most common), blood transfusion, hemodialysis, renal transplantation
If you have an acute disease HCV- the RNA tests ____ and serology is ____.
RNA tests positive serology negative
What are the serology tests for HBV and what are they looking for?
HBsAg is looking for the virus circulating in the bloodstream
Anti-HBs and Anti-HBc detects antibodies to HBV antigens
Positive for HBsAg, Anti-HBc IgM
What stage?
acute
Positive for Anti-HBc IgM
What stage?
window
Positive for Anti-HBs and Anti-HBc IgG
What stage?
early convalescence
Positive for Anti-HBc IgG
What stage?
late convalescence
What is the clinical definition of chronic hepatitis?
S antigen in blood stream for 6 months or longer
If someone has anti-HBe are they more or less infectious? More or less liver damage?
less infectious to others and less severe liver damage
If someone does not have anti-HBe are they more or less infectious? More or less liver damage?
more infectious to others and have more severe liver damage
Serology for chronic persistent HBV? Serology for chronic active HBV?
Chronic persistent: Positive for HBsAg, Anti-HBc IgG, Anti-HBe
Chronic active: Positive for HBsAg, Anti-HBc, IgG, HBeAg
Which virus is most likely to cause chronic hepatitis?
- HAV
- HBV
- HCV
- HDV
- HEV
HCV
Which virus, if acquired during pregnancy has a high mortality rate?
- HAV
- HBV
- HCV
- HDV
- HEV
HEV
HBV serology: HBs-Ag- positive, anti-HBs- negative, anti-HBc-IgM- positive
- early acute HBV
- window period
- convalescent HBV
- chronic HBV
- vaccinated for HBV
early acute HBV
HBV serology: HBs-Ag- negative, anti-HBs- negative, anti-HBc-IgM- positive
- early acute HBV
- window period
- convalescent HBV
- chronic HBV
- vaccinated for HBV
window period
HBV serology: HBs-Ag- negative, anti-HBs- positive, anti-HBc-IgM- positive
- early acute HBV
- window period
- convalescent HBV
- chronic HBV
- vaccinated for HBV
convalescent HBV
HBV serology: HBs-Ag- negative, anti-HBs- positive, anti-HBc-IgM- negative
- early acute HBV
- window period
- convalescent HBV
- chronic HBV
- vaccinated for HBV
vaccinated for HBV
HBV serology: HBs-Ag- positive for 8 months, anti-HBs- negative, anti-HBc-IgG- positive, HBeAg- positive, Anti-HBe- negative
- early acute HBV
- window period
- convalescent HBV
- chronic active HBV
- chronic persistent HBV
- vaccinated for HBV
chronic active HBV
Pt with fever, malaise, RUQ pain, jaundice, and hepatomegaly. No Hx of travel. Blood work: elevated AST and ALT, IgM to HAV- negative, IgG to HAV- positive, HBsAg- negative, anti-HBs- positive, anti-HBc- negative, HCV-RNA- positive, IgG to HCV- negative, IgG to HDV- negative. Which virus is causing this patient’s CURRENT condition?
- HAV
- HBV
- HCV
- HDV
- HEV
HCV
pt likely had HAV in the past, but since there is no IgM for HAV it is not the current problem
