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Unit 3 Microbio > L26: Viral Hepatitis > Flashcards

L26: Viral Hepatitis Flashcards

1
Q

icteric symptoms means

A

jaundice

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2
Q

Which hepatitises are acute?

A

A, E

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3
Q

Which hepatitises are chronic?

A

B, C, D

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4
Q

Hep A aka

A

infectious hepatitis

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5
Q

Hep B aka

A

serum hepatitis

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6
Q

Non, A, non B (NANB) hepatitis aka

A

Type C, Type D

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7
Q

Transfusion hepatitis aka

A

Type C

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8
Q

Delta agent aka

A

Type D hepatitis

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9
Q

Who gets Hep D?

A

ONLY Hep B patients

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10
Q

How many hepatitises are there?

A

At least 6, A-E

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11
Q

Hepatitis prodrome (pre-icteric phase)

A

Fatigue, malaise, anorexia

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12
Q

Icteric phase symptoms

A

Dark urine
Jaundice
Hepatomegaly
Elevated ALT, AST

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13
Q

4 possible courses for a hepatitis infection

A
  1. Subclinical + anicteric
    - seroconversion but no symptoms
  2. Typical acute icteric hepatitis
  3. Fulminant hepatitis
    - hep outside the liver=fatal
  4. Chronic: B, C, D
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14
Q

Hep A is found? when? transmission?

A

Worldwide (map shows high in south america, africa, asia)
No seasonality
Feces: food and water borne

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15
Q

How does Hep A get into your system?

A

Through intestine after ingestion

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16
Q

Hep A prognosis

A

mild, could be prolonged, resolves (acute)

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17
Q

Diagnose HAV

A

ELISA: IgM antibody

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18
Q

Treat Hep A acute viral hepatitis:

A

Bed rest, hydrate, eat

Avoid hepatotoxins: alcohol, drugs, anestesia

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19
Q

When to hospitalize Hep A

A

IV fluids needed

evidence of deteriorating liver function

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20
Q

If you’re exposed to Hep A

A

post-exposure prophylaxis in Ig (Amaguard)

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21
Q

foods that might be contaminated with Hep A

A

Shellfishies

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22
Q

Does Hep A have a vaccine?

A

Yep
Killed virus
You should get it

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23
Q

1 way you get Hep A as indicated by red circle

A

Personal contact

so education patients to break the chain

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24
Q

Primary hepatocellular carcinoma

A

Caused by Hep B (80%)

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25
Dane particle
double walled infectious form of Hep B
26
Where is Hep B found? How is it transmitted?
Worldwide Hyperendemic: China, Alaska, Africa Exposure to serum, blood, serum: needlessss
27
Who's the major reservoir for Hep B?
Chronic hepatitis patients | Virus shed while asymptomatic
28
Can babies get Hep B from their moms?
Yes, HBeAg in mother is greatest risk. | virtually all infected infants become *chronically* infected.
29
Populations at high risk for Hep B
*Healthcare workers* *IVDU* da gays da slutty straights Institutionalized persons Family contacts of infected individuals
30
Where does Hep B replicate? What's the incubation period?
Exclusively in the liver | 50-180 days, insidious onset
31
Hep B prodrome
Fever Urticarial rash Symmetrical arthralgias
32
Can Hep B be recognized while subclinical?
Yep, anti-HBsAg
33
Hep B prognosis
It's chronic, but self-limited. 10-15% fail to resolve technically it never cures as viral DNA is always present in cells
34
Chronic Hep B presentation
Increased LFTs Cirrhosis, liver failure portal htn, ascites
35
How does Hep B cause hepatocellular carcinoma?
promotion of liver repair and growth in response to tissue damage -or- due to viral integration directly
36
Rapid Hepatitis B virus tests
Detect HBV surface antigen
37
Can you cure HBV?
No, there are no curative tx | most patients resolve, however, they always have viral DNA in their cells
38
How do you treat chronic HBV?
PED-interferon + antivirals | biopsy to monitor liver damage and viral load
39
Is there an HBV vaccine?
Yes, subunit vaccine, include HDV | You've def had it
40
If you're exposed to HBV
Immunoglobulin prophylaxis within 1 week
41
Pregnant Mom is HBsAb+
newborn get immunoglobulin + vaccination
42
What does Hep D need for replication?
Presence of Hep B for helper functions
43
Hep D morphology
delta antigen/RNA | HBsAb which it has taken from Hep B
44
2 conditions for Hep D disease
1. Coinfection with HBV | 2. Superinfection with chronic HBV
45
In the end, what does Hep D do?
Makes HBV worse | fulminant hepatitis is more likely
46
How is Hep D spread?
Same ways as Hep B
47
Who's a Hep D reservoir?
Chronic HBV+HDV individuals
48
HDV diagnosis
ELISA: delta antigen or antibodies
49
Treat HDV
PEG-interferon + supportive therapy | -suppresses active virus replication
50
Does Hep D have a vaccine?
It's included in the Hep B vaccine
51
90% of NANB hepatitis is
Hep C
52
What's hepatitis notorious for
post-tranfusion hepatitis | hallmark: chronic infections (70-85%)
53
What do hep C chronic infections often progress to
Cirrhosis | Liver failure
54
How is Hep C transmitted?
Not well understood, hard to pinpoint Not known in >50% of cases Graph says 60% IVDU, 15% sex, 10% transfusion
55
Risk factors for Hep C
``` IVDU Hemodialysis Blood transfusions: prevalent in hemophilia Contact with health care providers +/- tattoos ```
56
Factors that promote HCV infection progression
``` ETOH >40 years Male Hep B co-infection HIV co-infection ```
57
Screening for HCV
Enzyme immunoassay: detects antibodies against HCV
58
When does seroconversion occur in Hep C?
~24 weeks after infection
59
Who often escapes HCV serology detection
Chronic state patients | acute phase viremic patients
60
What's useful to confirm negative HCV serology results?
Direct assays for virus
61
What treats +/- cures HCV?
Direct-acting antiviral agents (DAAs) | combination regimens vary with virus genotype (6)
62
What's the old treatment for HCV?
Ribavirin+interferon not that effective, not well tolerated
63
Is Hep C commonly caught in the acute phase?
No, its asymptomatic
64
Possible Hep C combinations
viral protease OR polymerase inhibitor | +/- alpha-interferon (PEG) depending on genotype
65
Prevention of Hep C
Blood screening | Identifying compensated, unrecognized infections
66
Leading cause of need for liver transplants
Cirrhosis Hepatocellular carcinoma Sometimes only curative option for HBV, HCV
67
Issues with transplants
Recurrent infection, patients are immunosuppressed | HCV(+) donors
68
What can cure Hep C?
Harvoni but it's costly af

Unit 3 Microbio (13 decks)

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