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IDIS GI Infections Flashcards

1
Q

Infectious esophagitis is associated with ____ and ____. What are the 3 main etiologies?

A

dysphagia and odynophagia

GERD, infections, medications

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2
Q

Infectious causes of esophagitis are:

What is most common?

A
  1. candida albicans (most common)
  2. CMV
  3. HSV
  4. HIV
  5. VZV
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3
Q

What is unique to esophagitis?

A

odynophagia

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4
Q

What is key with esophagitis caused by HSV?

A

abrupt onset

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5
Q

What is key with esophagitis caused by CMV?

A

gradual onset of Sx

only occurs in IC hosts

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6
Q

What is the most common cause of chronic active gastritis and peptic ulcer disease?

A

Helicobacter pylori

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7
Q

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?

A

chronic active gastritis

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8
Q

Gnawing or burning epigastric pain, bleeding that results in anemia weakness or fatigue, hematemesis melena or hematochezia, gastric or duodenal ulcers

Dx?

A

peptic ulcer disease

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9
Q

Pain is made worse by eating in ___ ulcers, but better with eating or taking antacids in ___ ulcers.

A

gastric ulcers- worse

duodenal ulcers- better

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10
Q

Most common cause of esophagitis?

  1. HSV
  2. CMV
  3. HIV
  4. Candida albicans
  5. Streptococcus pyogenes
A

Candida albicans

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11
Q

60 y/o, epigastric pain, hurts most in morning and 2hr after eating, melena noted. Ulcer noted in duodenum on EGD. Most likely diagnosis?

  1. Esophagitis
  2. Gastritis
  3. Peptic ulcer disease
  4. Hepatitis
A

Peptic ulcer disease

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12
Q

Which hepatitis would need a history of travel?

A

HEV- 20% mortality rate in pregnant women

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13
Q

Which hepatitis has a chronic carrier state?

A

HBV and HCV have chronic carrier states

HAV and HEV do NOT

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14
Q

____ has a mortality rate 10 times that of ____.

A

HEV, HAV

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15
Q

Eating raw or undercooked shellfish, daycare facilities, areas with poor sanitation practices, travel to developing countries, MSM, healthcare institutions, food service, illicit drug users

A

HAV

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16
Q

EIA for IgM and IgG for ____.

  • Positive for IgM = _______ infection
  • Positive for IgG = _______ infection
A

HAV
acute HAV- IgM
previous HAV- IgG

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17
Q

Chronic hepatitis: ___ is more likely to be asymptomatic compared to ___.

A

HCV, HBV

18
Q

Fulminant hepatitis occurs in ____ of patients.

A

1%

19
Q

HCV has __ to __% of chronic cases compared to HBV having __ to __%

A

HCV 70-85%

HBV 5-10%

20
Q

Primary hepatocellular carcinoma: ___ is associated with 80% of the cases of liver carcinoma.

A

HBV

21
Q

Most common route for transmission of HBV?

A

sexual contact

22
Q

Most common route for transmission of HCV?

A

percutaneous routes: injection of drug use (most common), blood transfusion, hemodialysis, renal transplantation

23
Q

If you have an acute disease HCV- the RNA tests ____ and serology is ____.

A

RNA tests positive serology negative

24
Q

What are the serology tests for HBV and what are they looking for?

A

HBsAg is looking for the virus circulating in the bloodstream

Anti-HBs and Anti-HBc detects antibodies to HBV antigens

25
Q

Positive for HBsAg, Anti-HBc IgM

What stage?

A

acute

26
Q

Positive for Anti-HBc IgM

What stage?

A

window

27
Q

Positive for Anti-HBs and Anti-HBc IgG

What stage?

A

early convalescence

28
Q

Positive for Anti-HBc IgG

What stage?

A

late convalescence

29
Q

What is the clinical definition of chronic hepatitis?

A

S antigen in blood stream for 6 months or longer

30
Q

If someone has anti-HBe are they more or less infectious? More or less liver damage?

A

less infectious to others and less severe liver damage

31
Q

If someone does not have anti-HBe are they more or less infectious? More or less liver damage?

A

more infectious to others and have more severe liver damage

32
Q

Serology for chronic persistent HBV? Serology for chronic active HBV?

A

Chronic persistent: Positive for HBsAg, Anti-HBc IgG, Anti-HBe

Chronic active: Positive for HBsAg, Anti-HBc, IgG, HBeAg

33
Q

Which virus is most likely to cause chronic hepatitis?

  1. HAV
  2. HBV
  3. HCV
  4. HDV
  5. HEV
A

HCV

34
Q

Which virus, if acquired during pregnancy has a high mortality rate?

  1. HAV
  2. HBV
  3. HCV
  4. HDV
  5. HEV
A

HEV

35
Q

HBV serology: HBs-Ag- positive, anti-HBs- negative, anti-HBc-IgM- positive

  1. early acute HBV
  2. window period
  3. convalescent HBV
  4. chronic HBV
  5. vaccinated for HBV
A

early acute HBV

36
Q

HBV serology: HBs-Ag- negative, anti-HBs- negative, anti-HBc-IgM- positive

  1. early acute HBV
  2. window period
  3. convalescent HBV
  4. chronic HBV
  5. vaccinated for HBV
A

window period

37
Q

HBV serology: HBs-Ag- negative, anti-HBs- positive, anti-HBc-IgM- positive

  1. early acute HBV
  2. window period
  3. convalescent HBV
  4. chronic HBV
  5. vaccinated for HBV
A

convalescent HBV

38
Q

HBV serology: HBs-Ag- negative, anti-HBs- positive, anti-HBc-IgM- negative

  1. early acute HBV
  2. window period
  3. convalescent HBV
  4. chronic HBV
  5. vaccinated for HBV
A

vaccinated for HBV

39
Q

HBV serology: HBs-Ag- positive for 8 months, anti-HBs- negative, anti-HBc-IgG- positive, HBeAg- positive, Anti-HBe- negative

  1. early acute HBV
  2. window period
  3. convalescent HBV
  4. chronic active HBV
  5. chronic persistent HBV
  6. vaccinated for HBV
A

chronic active HBV

40
Q

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?

  1. HAV
  2. HBV
  3. HCV
  4. HDV
  5. HEV
A

HCV

pt likely had HAV in the past, but since there is no IgM for HAV it is not the current problem

GI (10 decks)

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