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Patho Exam #4 > Liver > Flashcards

Liver Flashcards

1
Q

Inflammation of the liver parenchyma

A

Acute Viral Hepatitis

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2
Q

Caused by many viruses

Cytomegalovirus, Epstein-Barr

A

Acute Viral Hepatitis

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3
Q 
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D (Delta)
Hepatitis E
are \_\_\_\_\_\_\_ hep
A

viral

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4
Q

RNA virus spread by fecal-oral route

Also called enteric hepatitis

A

Hepatitis A (HAV)

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5
Q

2- to 7-week incubation period

A

Hepatitis A (HAV)

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6
Q

Prodromal period of _______ includes

Jaundice, RUQ pain. malaise, anorexia, nausea, low-grade fever, children may not experience jaundice

A

Hepatitis A (HAV)

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7
Q

Followed by jaundice lasting approx 2 weeks

Self-limited course

A

Hepatitis A (HAV)

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8
Q 
Prevention
Careful hand washing
Segregation
Cleaning of laundry and personal items
Immunization and γ-globulin
A

Hepatitis A (HAV)

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9
Q

Treatment includes:
Supportive (rest, nutritious diet)
Avoid ETOH, acetaminophen, hepatotoxins

A

Hepatitis A (HAV)

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10
Q

Serologic testing for _____ includes
Anti-HAV IgG (____ infection)
IgM (____infection)

A

Hepatitis A (HAV); previous; acute

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11
Q

Partially double-stranded DNA virus
Spread by parenteral contact with infected blood or blood products
Includes contaminated needles and sexual contact

A

Hepatitis B (HBV)

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12
Q

Also called serum hepatitis
300 million (5%) of world population have chronic infection
1 to 1.25 million in United States

A

Hepatitis B (HBV)

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13
Q

Risk factors
Perinatal, health care settings (3%); transfusions and dialysis (1%); acupuncture, tattooing, extended overseas travel, residence in an institution

A

Hepatitis B (HBV)

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14
Q

Incubation period of 2 to 6 months

A

Hepatitis B (HBV)

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15
Q

Prodromal period
Asymptomatic or rashes, arthralgia, arthritis, angioedema, serum sickness, glomerulonephritis, jaundice (lasting 2 weeks on average)

A

Hepatitis B (HBV)

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16
Q

Treatment

Persons with detectable virus and HBeAg positive readily transmit virus to their contacts, and should be counseled

A

Hepatitis B (HBV)

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17
Q

Most nonfulminant infections resolve spontaneously

About 5% progress to chronic infection

A

Hepatitis B (HBV)

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18
Q

Liver transplant treatment for

A

Hepatitis B (HBV)

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19
Q

Surface antigen (HBsAg)

A

early/active and chronic infection in Hepatitis B (HBV)

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20
Q

Surface antibody (HbsAb)

A

resolution and immunity in Hepatitis B (HBV)

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21
Q

Core antigen (HBcAg)

A

appears first in active infection in Hepatitis B (HBV)

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22
Q

Core antibody (HBcAb)

A

seroconversion in Hepatitis B (HBV)

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23
Q

Hepatitis B e antigen (HBeAg):

A

viral replication and infectivity n Hepatitis B (HBV)

24
Q

Interferon-alpha
24 to 48 weeks of therapy
Response rate of 33%
treatment for ______

A

Hepatitis B (HBV)

25
Q

Lamivudine, Telbivudine
Adefovir, Tenofovir
treatment for _____

A

Hepatitis B (HBV)

26
Q

Entecavir (treatment of choice)
Response rate of 67%
Extremely expensive

treatment for ______

A

Hepatitis B (HBV)

27
Q

Immunizations for _____
Doses given at 0, 1, and 6 months
95% response rate
Recommended as part of the childhood vaccination regimen and for high-risk individuals, and after exposure

A

Hep B (HBV)

28
Q

Prevention of _______

Administration of HBIG postinoculation

A

Hep B (HBV)

29
Q

Contains high levels of hepatitis B surface antibody

Given within 7 days of exposure

A

HBIG postinoculation

30
Q

Neonates born to HBsAg-positive mothers
Prophylaxis after needlestick or sexual exposure in nonimmune persons
After liver transplantation in patients who are HBsAg+ prior to transplantation
indications of exposure to ________

A

Hep B (HBV)

31
Q

Single-stranded RNA virus (Flavivirus)

Spread through IV drug use or blood transfusions prior to 1990

A

Hepatitis C (HCV)

32
Q

Also called non-A, non-B hepatitis

3% worldwide infected

A

Hepatitis C (HCV)

33
Q

Have 6 types

A

Hepatitis C (HCV)

34
Q

most common in the United States but has a lower response rate to treatment

A

Type 1 HCV

35
Q

common in N. America

A

Type 2-3 HCV

36
Q

common overseas

A

Types 4-6 HCV

37
Q

Usually asymptomatic

Course is erratic with wide fluctuations on liver enzymes

A

Acute HCV infection

38
Q

Usually asymptomatic until advanced liver disease intervenes

Most common cause of end-stage liver disease with cirrhosis

A

Chronic HCV infection

39
Q

Treatment for _______ infection of _____

Supportive and expectant
Early treatment not recommended

A

acute; HCV

40
Q

20% to 40% of acute seropositive patients will convert to seronegativity and an undetectable viral load during 1st 6 months after infection
Immune globulin is not helpful in preventing infection

in _______ infection of _____

A

acute; HCV

41
Q

Treatment for _______ infection of _____

Assessed by a viral load and viral genotype
Liver biopsy to stage disease activity

A

chronic; HCV

42
Q

Treatment for ________ infection of ______

Pegylated interferon-alpha with ribavirin and protease inhibitor
5% to 10% drop out of treatment because of side effects and cost (expensive)
Type 1: 48 weeks
Other types: 24 weeks

A

chronic; HCV

43
Q

Treatment for ______ active _____

Counsel regarding blood-borne precautions

Centers for Disease Control and Prevention does not currently recommend barrier methods for patients with long-term sexual partners because of the apparent low risk of infection

A

chronic; Hep C

44
Q

Treatment for chronic active hepatitis C infection

includes vaccinating against hep _____ and _____

A

A and B

45
Q

Defective RNA virus that requires the helper function of HBV to replicate
Infection appears to accelerate and worsen HBV infection symptoms
Prevention of HBV infection also prevents infection

A

Hepatitis D (Delta)

46
Q

Transmitted parenterally and intimate contact

Prevention of HBV infection also prevents infection

A

Hepatitis D (Delta)

47
Q

Prevention
Safe sexual practices
Avoidance of IV drug use
Vaccination of susceptible persons with HBV vaccine

A

Hepatitis D (Delta)

48
Q

No specific treatment

A

Hepatitis D (Delta)

49
Q

Diagnosis

Anti-HDV IgM and IgG enzyme linked immunosorbent assay (ELISA)

A

Hepatitis D (Delta)

50
Q

RNA virus spread via fecal-oral route
Contaminated H2O
Parenteral transmission

A

Hepatitis E (HEV)

51
Q

Most common in developing countries or recent travel to these areas
Relatively high mortality rate in pregnant women

A

Hepatitis E (HEV)

52
Q

Incubation period is 2 to 9 weeks

A

Hepatitis E (HEV)

53
Q

Prevention
Careful hand washing
Avoidance of undercooked foods
Drinking safe H2O and beverages

A

Hepatitis E (HEV)

54
Q

Supportive treatment

A

Hepatitis E (HEV)

55
Q

Prodromal and icteric illness
Usually last only 2 weeks
Similar to HAV infection

A

Hepatitis E (HEV)

Patho Exam #4 (7 decks)

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