Liver

Question 1

Fecal oral transmission of hepatitis ?

Answer 1

A and E

Question 2

Hepatitis A

Answer 2

Naked RNA virus

Question 3

Acute inf hepatitis A is diagnosed by?

Answer 3

Detection of HAV-IgM in serum by EIA (elisa)

Past infection : detection of HAV-IgG by EIA

Cell culture difficult and takes 4 weeks
Direct detection: pcr of feces but not done

Question 4

Hepatitis B incubation period

Answer 4

Average 60-90 days

Question 5

Treatment of hepatitis B

Answer 5

Interferon for HBeAg +ve carriers with chronic active hepatitis
Response 30-40%

Lamivudine
Entecavir
Tenofovir

Successful response -> disappearance of HBsAg, HBV-DNA and seroconversion to HBeAg

Question 6

Hepatitis C

Answer 6

Genome resembles that of a flavivirus

Question 7

Hepatitis C incubation period
Clinical illness jaundice?
Chronic hepatitis?

Answer 7

Average 6-7 weeks
Jaundice in 30-40%
Chronic hep 70%

Question 8

How to diagnose hep C ?

Answer 8

Generally HCV antibody (not in acute phase takes 4weeks bef antibodies appear)

HCV rna
Hcv antigen
Can be used for acute phase

Question 9

Non invasive serum based test for detection of fibrosis

Answer 9

Fibro test

Fibrospect II

Apri

For s fibrosis index

FIB-4

Question 10

Hepatic elastography

Answer 10

Ultra sound for liver fibrosis

Question 11

Assessing Cirrhosis severity

Answer 11

Child Pugh Score

Model for end stage liver disease score

Question 12

What cause Ascites ?

Answer 12

Portal hypertension and increases in nitrous oxide

Question 13

Hepatic encephalopathy

Answer 13

When toxin accumulate in gut and inflitrate brain
Potentially reversible

Symptoms 
Alterations in sleep 
Difficult focusing 
Altered consciousness 
Asterixis

Question 14

Hbv how many people have been infected?

Answer 14

2 billions !!!!!!!
Leading cause of cirrhosis and HCC worldwide

HBV is 50-100 times more infectious than HIV

Question 15

How many genotypes has HBV

Answer 15

8

Genotype B associated worh less active diseases and lower incidence pf HCC than genotype C

Genotypes A and B respond better to IFN than genotype C and D

Question 16

Hep B disease progression

Answer 16

90% of infected infants progress to disease
-5% of immunocompetent progress to disease

Chronic infect -> 30 % liver cancer, cirrosis

Question 17

HBsAg

Answer 17

Marker of CHRONIC hep B

Question 18

Anti HBs

Answer 18

Marker of immunity

Question 19

HBeAg

Answer 19

Index of active viral replication and high infectivity

Question 20

Anti HBe

Answer 20

Appears in recovery phase or reactivation phase

Question 21

Anti HBc

Answer 21

Marker of past and possibly current infection

Question 22

Normal ALT levels

Answer 22

Males 30 U/L

Females 19 U/L

Question 23

First line treatment for chronic HBV

Answer 23

Entecavir
Peginterferon alfa 2a
Tenofovir

Question 24

What cause HBV REACTIVATION

Answer 24

Corticosteroids
Antitumir antibiotics
Plant alkaloids (vinblastine vincristine)
Alkylating agents
Antimetabolites
Monoclonal antibodies
Others colaspase, docetaxel, etoposide, fludarabine, folinic acid, interferon, procarbazine

Question 25

What to do with HBsAg positive ?

Answer 25

Receive preventive antiviral therapy