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Upper GI > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What type of virus is HAV?

A

+ssRNA naked icosahedral picornavirus

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2
Q

Transmission of HAV?

A

fecal oral

  • acid stable
  • found in contaminated water in developing countries
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3
Q

How to inactivate HAV?

A
  1. Chlorinate
  2. Bleach
  3. UV irradiation
  4. Boil
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4
Q

HAV transmission in USA?

A
  • shellfish

- travelers to endemic areas

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5
Q

HAV symptoms in children?

A

No jaundice with vomit

  • often asymptomatic
  • shed virus to family
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6
Q

HAV symptoms in adults?

A

Jaundice and vomit

-smokers acquire an aversion to smoking

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7
Q

Duration of HAV?

A
  • one month
  • self limiting
  • no chronic state
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8
Q

Who should get the HAV vaccine?

A
  • high risk endemic areas
  • liver disease
  • homosexuals
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9
Q

Type of virus HBV?

A

partially dsDNA covalently closed circular hepadnavirus with envelope (cccDNA)

  • replicates in and out of nucleus through RNA intermediate
  • fully ds during replication
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10
Q

Key enzyme in HBV?

A

reverse transcriptase

-doesnt integrate into host

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11
Q

HBV transmission?

A
  • sex
  • needles
  • vertical transmission from mother
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12
Q

Who is at high risk of Chronic HBV?

A

Newborns (90%)

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13
Q

Extrahepatic manifestations of HBV?

A
  • arthralgias
  • PAN: beads on a string (decreased GFR)
  • MGN
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14
Q

HBV liver enzymes?

A

Elevated ALT>AST and then fall after infection

-normal ALT early in neonatal hepatitis

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15
Q

HBsAg+?

A

active infection

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16
Q

HBeAg+?

A

High infectivity

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17
Q

Anti-HBc?

A
  • positive in window period
  • Ab started to bind Ag, neither Ag nor Ab detected
  • false reassurance
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18
Q

Anti-HBe?

A

low infectivity

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19
Q

Anti-HBsAg?

A

Immunity

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20
Q

Immunized serology?

A

-Anti-HBc and Anti-HBe

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21
Q

Long term complications of HBV?

A
  • cirrhosis

- HCC

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22
Q

HDV virus type?

A

-ssRNA circular enveloped

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23
Q

What does HDV require to be infectious?

A

HBsAg

24
Q

Coinfection?

A

HBV and HDV simultaneously

-low risk of chronic

25
Q

Superinfection?

A

HDV infection on top of preexisting HBV

  • worse outcome, high risk of severe chronic
  • HDV uses HBV surface Ag to form envelope and spread
26
Q

Treatment for HBV?

A
  • NRTI (Lamivudine) that inhibits reverse transcriptase
  • Tenofovir
  • Entecavir
  • IFN-gamma
  • give to pregnant women prior to delivery
  • give baby IgG + HBV vaccine for active and passive immunity
27
Q

HCV type of virus?

A

+ssRNA enveloped Flavivirus

28
Q

HCV transmission?

A
  • Transfusions
  • IVDA
  • Sex (more common in HBV)
29
Q

Why is HCV very infectious?

A

antigenic variability

  • polymerase lacks 3’ to 5’ exonuclease activity leading to mutations
  • more infectious than HIV
30
Q

How much HCV becomes chronic?

A

60-80%

31
Q

Long term complications of HCV?

A
  • Cirrhosis

- HCC

32
Q

ALT levels in HCV?

A

rise and falls by 6 months indicates acute hepatitis

33
Q

Anti-HCV Ab and immunity?

A

antibodies may be present but not confer immunity due to HCV ability to mutate

34
Q

Chronic HCV requirements?

A

viral RNA persists for 6 months

35
Q

Cryoglobulins associated with what?

A

HCV

-precipitate with cool temp containing IgM

36
Q

Treatment of HCV?

A
  • Ribaviron
  • IFN alpha
  • protease inhibitor (NS5B)
37
Q

Leading cause of liver transplant?

A

HCV

38
Q

HEV type of virus?

A

Naked icosahedral RNA hepevirus

39
Q

Pregnant woman with acute liver disease dies?

A

HEV

40
Q

Marker for higher HBV infectivity?

A

HBeAg

-secreted by infected cells

41
Q

HCV and HIV confections?

A

shorter time to cirrhosis

42
Q

Keys to HCV replication?

A
  • forms membranous web

- Lipo viral particle forms with HCV and VLDL

43
Q

Most common risk factors for HAV transmission?

A
  • international travel

- IVDA

44
Q

Most common risk factors for HBV and HCV transmission?

A
  • IVDA

- multiple sex partners

45
Q

Major risk factor for HDV transmission?

A

IVDA

46
Q

Incubation period for HAV?

A

2-8 weeks

47
Q

Incubation period for HCV, HBV, HDV?

A

6 weeks to 6 months

48
Q

Chronic hepatitis?

A

viral Ag > 6 months

49
Q

Immune tolerant HBV?

A
  • normal ALT
  • high HBeAg and HBV DNA
  • infected as infant
50
Q

HBeAg+ immune active HBV?

A
  • HBsAg+ longer than 6 months
  • HBeAg+
  • anti-HBe negative
  • high serum HBV DNA
51
Q

Inactive carrier of HBV?

A
  • HBsAg+ > 6 months
  • HBeAg negative
  • Anti-HBe+
  • low HBV DNA
52
Q

HBeAg-, immune active HBV?

A
  • HBsAg+ > 6 months
  • HBeAg-
  • Anti-HBe+
  • low HBV DNA
53
Q

Diagnosis of HAV?

A
  • HAV IgM for acute
  • HAV IgG for prior exposure
  • increased ALT
54
Q

Diagnosis of HEV?

A
  • HEV IgM for acute

- HEV IgG past infection

55
Q

Diagnosis of HDV confection?

A

IgM and IgG both detected

56
Q

Acute HCV and ALT levels?

A

elevated >7x normal

Upper GI (5 decks)

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