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Lec 19 Hepatitis ABCs Flashcards

1
Q

What types of hepatitis can become chronic?

A

Hep B, C, D

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2
Q

How do you diagnose viral hepatitis?

A

by serology –> liver biopsy does not distinguish between them

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3
Q

What signs/symptoms of viral hepatitis?

A
  • fever
  • jaundice
  • high ALT/AST
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4
Q

How do you diagnose Hep A?

A

IgM anti-HAV during acute phase

usually positive w/in 2 weeks of symptom presentation

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5
Q

What is morphology of Hep A? [DNA/RNA, stranded]?

A

single stranded RNA

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6
Q

What family of virus if hep A?

A

picornavirus

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7
Q

What does IgG anti-HAV tell you?

A

tells you the patient previously had Hep A

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8
Q

How is hep A transmitted?

A

fecal-oral

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9
Q

How does hep A present?

A

mostly asymptomatic in adults; affects children more

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10
Q

What is treatment for Hep A?

A

usually self-limited

supportive treatment

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11
Q

What is prophyxlaxis for hep A?

A

inactivated/killed virus vaccine

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12
Q

What are 3 potential complications of Hep A?

A
  • cholestatic hepatitis
  • fulminant hepatic failure
  • relapsing Hep A
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13
Q

Which hepatitis is most common cause of acute and chronic liver disease and hepatocellular carcinoma?

A

Hep B

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14
Q

What is morphology of Hep B [DNA/RNA, stranded]?

A

double stranded DNA virus

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15
Q

What is hepatitis E antigen?

A

marker of HBV replication and infectivity = envelope antigen

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16
Q

How long does it take from start of infection to symptom onset in HBV?

A

60-90 days

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17
Q

What does HBV DNA tell you?

A

quantitiative marker of replication

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18
Q

What does HBeAg tell you?

A

marker of Hep B viral replication and infectivity

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19
Q

What does HBsAg tell you? When is it detectable?

A

first detectable marker upon acute infection

precedes rise in AST/ALT and symptoms

undetectable 1-2 months after onset of jaundice

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20
Q

What does positive anti-HBs antibody tell you?

A
  • received HBV vaccination OR cleared acute HBV infection
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21
Q

Which HBV markers are positive in acute HBV of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?

A
  • HBsAg
  • HBeAg
  • anti-HBc IgM
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22
Q

Which HBV markers are positive in window period of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?

A
  • anti-HBe

- anti-HBC IgM

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23
Q

Which HBV markers are positive in chronic inactive HBV of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?

A
  • HBsAg
  • anti-HBe
  • anti-HBC IgG
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24
Q

Which HBV markers are positive after recovery of HBV of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?

A
  • anti-HBs
  • anti-HBe
  • anti-HBC IgG
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25
Which HBV markers are positive in an immunized patient of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?
anti-HBs only
26
Which HBV markers are positive in chronic active HBV of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?
- HBsAg - HBeAg - anti-HBC IgG
27
What defines chronic HBV?
persistent HBsAg
28
Is ALT or AST generally greater in viral hepatitis?
ALT > AST in viral hepatitis
29
What are escape mutants?
people who have loss of anti-HBs neutralizing activity have possibility of acquiring infection despite having anti-HBs from vaccination
30
How is Hep B transmitted?
- perenteral --> blood transfusion, needle stick, IV drug use - sexual - maternal-fetal
31
What is the most common cause of chronic viral hepatitis in Asia and Africa?
Hepatitis B
32
How is HBV usually acquired in childhood? Symptomatic or subclinical in acute stage?
acquired perinatally or in preschool infection = subclinical
33
How is HBV usually acquired in adulthood? Symptomatic or subclinical in acute stage?
acquired by sexual contact, injection drug use, or exposure to blood infection = symptomatic
34
From Hep B how many people go on to get chronic infection? neonates vs adults?
neonates --> 90% become chronic | adults --> 90% clear the virus
35
How do you get HCC without cirrhosis in hep B?
HBV integrates into the host genome and can act as an oncogene
36
What tumor marker is commonly elevated in pts wtih HCC?
alpha fetoprotein
37
What is incubation period for Hep C?
1-2 months
38
What is most sensitive indicator of Hep C infection?
HCV RNA
39
WHat is most common genotype of hep C in the US?
genotype 1
40
What family of viruses does HBV belong to?
DNA hepadnavirus
41
What family of viruses does HCV belong to?
RNA flavivirus
42
What is the morphology of HCV [DNA/RNA, strandedness]?
positive strand RNA
43
Are HCV infections usually asymptomatic or symptomatic?
usually asymptomatic
44
What is the most common cause of chronic viral hepatitis in USA and europe?
Hep C
45
How is Hep C transmitted?
primarily blood, sexual transmission, perinatal, injection drug use
46
What percentage of people with hep C go on to chronic disease?
50-70%
47
What is the best indicator of HCV treatment response?
sustained viral response at > 6 months after end of treatment
48
What is treatment for HCV [3 drugs together]?
combo protease inhibitor + pegylated interferon + ribavirin
49
When do you begin to detect HCV antibody?
detected at 1-3 months after acute infection
50
What is morphology of hepatitis D [DNA/RNA, stranded]?
single stranded RNA virus
51
What family of virus is hep D?
delta virus
52
Who gets hep D?
only in people that are infected with HBV --> required HBV for replication and expression
53
What is hep D superinfection?
acute hep D in presence of chronic Hep B
54
How do you diagnose hep D?
IgM anti-HDV
55
How is Hep D transmitted?
parenteral, sexual
56
Where is hep D endemic?
mediterranean, middle east, south america, africa
57
What is treatment for Hep D?
interferon
58
What is incubation period for hep E?
short = 1 month
59
How is hep E transmitted?
fecal oral
60
How do you diagnose Hep E virus?
anti-HEV IgM
61
Who is at risk for serious complications with hep E?
pregnant women --> can lead to fulminant hepatitis and death

GI/Liver (36 decks)

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