Liver 2 - viral hep

Question 1

3 things that can be happening in hepatitis

Answer 1

immune reaction to try to eradicate

1. new infection
2. drug induced liver injury
3. autoimmune

Question 2

which heps are always eradicated and which might go chroins

Answer 2

acute- A,E

chronic - BCD

Question 3

what is type, route, chronicity, and prevantion of AnddE

Answer 3

type: RNA
route: fecal oral
chronic: no
prevention: clean water

Question 4

how does transmission pattern of Aand E vary by endemics

Answer 4

high - person-person - uncommon outbreaks because peole immune
moderate - person-person - outbreaks common
very low - travelers, outbreaks uncommon

Question 5

how does ALT compare to Sx

Answer 5

similar levels becasue represents acute inflammation

Question 6

how does jaundice vary by age

Answer 6

older people tend to get it more

Question 7

2 complications of AE

Answer 7

1. fulminant hep - acute liver failure

2. cholestatic or relapsing

Question 8

mgmt of A,e

Answer 8

• supportive
• recover in month
• immunize household contacts

Question 9

mech in chronic hep

Answer 9

immune rxn fails to eradicate and get a downreguated immunity
- over time fibrosis repaces hepatocytes

Question 10

3 possible causes of chronic

Answer 10

1. viral BCD
2. drug
3. autoimmune

Question 11

4 characteristics of chronic inflammation

Answer 11

1. portal inlammation
2. interface inflammation
3. parenchyma=l inflammation
4. fibrosis

Question 12

steps of fibrosis

Answer 12

1. periportal parenchyma > enlarged portal tracts
2. portal-portal fibrous septa
3. portal central fibrous bridges

Question 13

classification of hep c

Answer 13

0 - no scar
1 - minimal scarring
2 - scarring extends into liver containing blood vessels
3. bridging fibrosis
4 cirrosis or advanced scarring

Question 14

what is type, route, chronicity, and prevantion of B and

D (only with B)

Answer 14

type: B- DNA, D RNA
route: blood
chronic: yes
prevention: harm reduction - B - vaccine

Question 15

how does age affect chronicity of BD

Answer 15

younger are likely to get chronic

Question 16

most likely way to get

Answer 16

blood, wound, serum

Question 17

what is special about B structure

Answer 17

can live outside envelope

Question 18

what does B serology tell us

Answer 18

HBsAg - infection
anti-HBs - immunity (resoved or vaccine)
anti-HBc - infection (IgM - acute)
HBeAg - infectious
anti- HBe - less infectious
HBV-DNA - viral load

Question 19

what happens in b spont recovery

Answer 19

able to wipe out virus

Question 20

what happens in b chronic

Answer 20

dont wipe out and it bounces back

Question 21

2 treatments - not cure

Answer 21

1. immune modulatory - interferon

2. viral supression -

Question 22

groups at risk

Answer 22

• people in endemic areas
• IDU
• MSM
• blood/organ donor
• hemodyalisis

Question 23

what is type, route, chronicity, and prevantion of C

Answer 23

type: RNA
route: blood
chronic: yes
prevention: harm reduction

Question 24

2 main risk groups

Answer 24

• immigrants

- IDU

Question 25

clinical features of C

Answer 25

• jaundice in 25%
• chronic infection
• cirrosis

Question 26

good news for hep C

Answer 26

now curable!