Liver (Hepatitis)

Question 1

viral hepatitis

Answer 1

Hepatitis A and E: spread feco-orally

Hepatitis B, C, and D: spread parenterally

Question 2

extremely contagious RNA enterovirus

Answer 2

hepatitis A

Question 3

spreads through contaminated food and water or through direct contact with infected individuals

Answer 3

hepatitis A

Question 4

at-risk individuals include MSM (men who have sex with men) and PWID (persons who inject drugs)

Answer 4

hepatitis A

Question 5

low- and middle-income populations at risk due to poor sanitary conditions and hygienic practices

Answer 5

hepatitis A

Question 6

does not lead to chronic infection

Answer 6

hepatitis A

Question 7

incubation period of 1-4 weeks

Answer 7

hepatitis A

Question 8

clinical symptoms of fever and malaise begin about 4 weeks post-infection with jaundice occurring around weeks 5 to 6

Answer 8

hepatitis A

Question 9

infected persons usually make full recovery following course of illness

Answer 9

hepatitis A

Question 10

virus present in stool 2 weeks before and 1 week after onset of jaundice, individuals still infected despite absence and resolution of symptoms

Answer 10

hepatitis A

Question 11

immunity via anti-HAV antibodies

Answer 11

hepatitis A

Question 12

 Two-dose vaccination

 First dose typically administered at 12-23 months of age with second dose given 6 moths later

Answer 12

hepatitis A

Question 13

Vaccine recommended for the following people:
• All children aged 12-23 months
• Unvaccinated children and adolescents aged 2-18 years
• International travelers
• At-risk populations (MSM, PWID, occupational hazards)
• People experiencing homelessness
• People with HIV
• People with chronic liver disease

Answer 13

hepatitis A

Question 14

similar to hepatitis A

Answer 14

hepatitis E

Question 15

single-stranded RNA virus

Answer 15

hepatitis E

Question 16

incubation period 15-60 days

Answer 16

hepatitis E

Question 17

Many infected individuals are asymptomatic or mildly symptomatic  
• Jaundice 
• Nausea 
• Vomiting
• Anorexia 
• Hepatomegaly

Answer 17

hepatitis E

Question 18

usually self-limited course of virus, but immunocompromised populations can develop chronic infection

Answer 18

hepatitis E

Question 19

diagnosis = IgM and anti-HEV antibodies

Answer 19

hepatitis E

Question 20

globally, liver disease caused by this is a serious problem (~400 million people are carriers, ~80% of all chronic carriers live in Asia and the Western Pacific rim)

Answer 20

hepatitis B

Question 21

found in the blood during the late stages of a prolonged incubation period: 4-26 weeks

Answer 21

hepatitis B

Question 22

present in all physiological and pathologic body fluids, except stool

Answer 22

hepatitis B

Question 23

can withstand extreme temperatures and humidity

Answer 23

hepatitis B

Question 24

spread by contact with bodily secretions

Answer 24

hepatitis B

Question 25

in endemic regions, vertical transmission from mother to child during birth constitutes main mode of transmission

Answer 25

hepatitis B

Question 26

in areas of low prevalence, horizontal transmission via blood transfusion, dialysis, needlestick accidents, needle sharing among IV drug users, and sexual transmission

Answer 26

hepatitis B

Question 27

chronically infected patients are at increased risk for hepatocellular carcinoma

Answer 27

hepatitis B and C

Question 28

``` Four clinical patterns:  Acute self-limited hepatitis  Fulminant acute hepatitis  Chronic hepatitis  Asymptomatic chronic infection ```

Answer 28

hepatitis B

Question 29

largely prevented by vaccination and the screening of donor blood, organs, and tissues

Answer 29

hepatitis B

Question 30

vaccination produces a protective anti-HBS antibody

Answer 30

hepatitis B

Question 31

usually given 2, 3, or 4 injections of vaccine

Answer 31

hepatitis B

Question 32

infants should be given first dose at birth and complete series at 6 months of age

Answer 32

hepatitis B

Question 33

adults who have Hep __ + sex partner, people who share needles, healthcare workers, travelers to regions with increased Hep __ rates, anyone who wants to be protected

Answer 33

hepatitis B

Question 34

major cause of liver disease (~175 million people worldwide are carriers)

Answer 34

hepatitis C

Question 35

persistent chronic infection is present in 3-4 million in the US

Answer 35

hepatitis C

Question 36

new cases have dropped since the mid 1980s due to reduction in transfusion-associated Hep __ and decline in infection between IV drug users

Answer 36

hepatitis C

Question 37

death rate will continue to rise due to the decades long lag time between acute infection and liver failure

Answer 37

hepatitis C

Question 38

major route of transmission in US: blood inoculation, with IV drug use accounting for 60%

Answer 38

hepatitis C

Question 39

occupational exposure (healthcare workers) account for 4% of cases

Answer 39

hepatitis C

Question 40

single condition most frequently necessitating liver transplantation in the US

Answer 40

hepatitis C

Question 41

much higher rate of progression to chronic disease and eventual cirrhosis than Hep B

Answer 41

hepatitis C

Question 42

positive ss-RNA virus belonging to the Flavividae family

Answer 42

hepatitis C

Question 43

subclassified into 6 genotypes based on genetic sequence

Answer 43

hepatitis C

Question 44

quasispecies (many variants)

Answer 44

hepatitis C

Question 45

no vaccine

Answer 45

hepatitis C

Question 46

incubation period of 2-26 weeks, average of 6-12 weeks

Answer 46

hepatitis C

Question 47

asymptomatic in 75% of affected persons

Answer 47

hepatitis C

Question 48

RNA can be detected in blood within days to 8 weeks depending on size of inoculation

Answer 48

hepatitis C

Question 49

neutralizing anti-HC_ antibodies develop within weeks to a few months but do NOT confer effective immunity

Answer 49

hepatitis C

Question 50

a strong immune response involving CD4+ and CD8+ cells are associated with self-limited infections

Answer 50

hepatitis C

Question 51

persistent infection is the HALLMARK of infection, seen in 80-85% of patients with clinical or asymptomatic acute infection

Answer 51

hepatitis C

Question 52

cirrhosis will develop in 20% of persistently infected patients, can be present at time of diagnosis or may take up to 20 years

Answer 52

hepatitis C

Question 53

some patients will have decades long chronic infection without progressing to cirrhosis

Answer 53

hepatitis C

Question 54

fulminant hepatitis is rare

Answer 54

hepatitis C

Question 55

unique RNA virus that is replication-defective (only causes infection when encapsulated by HbsAg)

Answer 55

hepatitis D

Question 56

dependent on HBV coinfection for multiplication

Answer 56

hepatitis D

Question 57

Infection occurs in 2 ways:  Acute coinfection after exposure to serum containing both HDV and HBV (HBV infection must be established first, followed by HBsAg made in sufficient amounts for HDV virions to be produced)  Super infection of a chronic carrier of HBV with a new inoculum of HDV

Answer 57

hepatitis D

Question 58

most superinfected persons experience an acceleration of hepatitis, progressing to a more severe chronic hepatitis 4-7 weeks later

Answer 58

hepatitis D

Question 59

in the US, infection is largely restricted to PWID and persons receiving multiple blood transfusions

Answer 59

hepatitis D

Question 60

most reliable indicator of HDV exposure

Answer 60

IgM and anti-HDV