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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
Q

Dane particle

A

double walled infectious form of Hep B

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26
Q

Where is Hep B found? How is it transmitted?

A

Worldwide
Hyperendemic: China, Alaska, Africa
Exposure to serum, blood, serum: needlessss

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27
Q

Who’s the major reservoir for Hep B?

A

Chronic hepatitis patients

Virus shed while asymptomatic

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28
Q

Can babies get Hep B from their moms?

A

Yes, HBeAg in mother is greatest risk.

virtually all infected infants become chronically infected.

29
Q

Populations at high risk for Hep B

A

Healthcare workers
IVDU
da gays
da slutty straights
Institutionalized persons
Family contacts of infected individuals

30
Q

Where does Hep B replicate? What’s the incubation period?

A

Exclusively in the liver

50-180 days, insidious onset

31
Q

Hep B prodrome

A

Fever
Urticarial rash
Symmetrical arthralgias

32
Q

Can Hep B be recognized while subclinical?

A

Yep, anti-HBsAg

33
Q

Hep B prognosis

A

It’s chronic, but self-limited.
10-15% fail to resolve
technically it never cures as viral DNA is always present in cells

34
Q

Chronic Hep B presentation

A

Increased LFTs
Cirrhosis, liver failure
portal htn, ascites

35
Q

How does Hep B cause hepatocellular carcinoma?

A

promotion of liver repair and growth in response to tissue damage
-or-
due to viral integration directly

36
Q

Rapid Hepatitis B virus tests

A

Detect HBV surface antigen

37
Q

Can you cure HBV?

A

No, there are no curative tx

most patients resolve, however, they always have viral DNA in their cells

38
Q

How do you treat chronic HBV?

A

PED-interferon + antivirals

biopsy to monitor liver damage and viral load

39
Q

Is there an HBV vaccine?

A

Yes, subunit vaccine, include HDV

You’ve def had it

40
Q

If you’re exposed to HBV

A

Immunoglobulin prophylaxis within 1 week

41
Q

Pregnant Mom is HBsAb+

A

newborn get immunoglobulin + vaccination

42
Q

What does Hep D need for replication?

A

Presence of Hep B for helper functions

43
Q

Hep D morphology

A

delta antigen/RNA

HBsAb which it has taken from Hep B

44
Q

2 conditions for Hep D disease

A
  1. Coinfection with HBV

2. Superinfection with chronic HBV

45
Q

In the end, what does Hep D do?

A

Makes HBV worse

fulminant hepatitis is more likely

46
Q

How is Hep D spread?

A

Same ways as Hep B

47
Q

Who’s a Hep D reservoir?

A

Chronic HBV+HDV individuals

48
Q

HDV diagnosis

A

ELISA: delta antigen or antibodies

49
Q

Treat HDV

A

PEG-interferon + supportive therapy

-suppresses active virus replication

50
Q

Does Hep D have a vaccine?

A

It’s included in the Hep B vaccine

51
Q

90% of NANB hepatitis is

A

Hep C

52
Q

What’s hepatitis notorious for

A

post-tranfusion hepatitis

hallmark: chronic infections (70-85%)

53
Q

What do hep C chronic infections often progress to

A

Cirrhosis

Liver failure

54
Q

How is Hep C transmitted?

A

Not well understood, hard to pinpoint
Not known in >50% of cases
Graph says 60% IVDU, 15% sex, 10% transfusion

55
Q

Risk factors for Hep C

A 
IVDU
Hemodialysis
Blood transfusions: prevalent in hemophilia
Contact with health care providers
\+/- tattoos
56
Q

Factors that promote HCV infection progression

A 
ETOH
>40 years
Male
Hep B co-infection
HIV co-infection
57
Q

Screening for HCV

A

Enzyme immunoassay: detects antibodies against HCV

58
Q

When does seroconversion occur in Hep C?

A

~24 weeks after infection

59
Q

Who often escapes HCV serology detection

A

Chronic state patients

acute phase viremic patients

60
Q

What’s useful to confirm negative HCV serology results?

A

Direct assays for virus

61
Q

What treats +/- cures HCV?

A

Direct-acting antiviral agents (DAAs)

combination regimens vary with virus genotype (6)

62
Q

What’s the old treatment for HCV?

A

Ribavirin+interferon

not that effective, not well tolerated

63
Q

Is Hep C commonly caught in the acute phase?

A

No, its asymptomatic

64
Q

Possible Hep C combinations

A

viral protease OR polymerase inhibitor

+/- alpha-interferon (PEG) depending on genotype

65
Q

Prevention of Hep C

A

Blood screening

Identifying compensated, unrecognized infections

66
Q

Leading cause of need for liver transplants

A

Cirrhosis
Hepatocellular carcinoma
Sometimes only curative option for HBV, HCV

67
Q

Issues with transplants

A

Recurrent infection, patients are immunosuppressed

HCV(+) donors

68
Q

What can cure Hep C?

A

Harvoni but it’s costly af

Unit 3 Microbio (13 decks)

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