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Sem 4, case 5 (hepatitis) > pathophysiology of viral hepatitis (ninja nerd) > Flashcards

pathophysiology of viral hepatitis (ninja nerd) Flashcards

1
Q

What is meant by an ‘Acute Infection’ of hepatitis ?

A

The body can rid of the virus in <6months

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2
Q

What is meant by a ‘Chronic Infection’ of hepatitis ?

A

Lasts longer than 6months

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3
Q

Is Hep A an acute or chronic infection ?

A

Acute

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4
Q

How is Hep A transmitted ?

A

fecal-oral route

= patient ingested faeces of an infected person

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5
Q

What is the structure of Hep A virus like ?

A
  • no envelope (no phospholipid bilayer surrounding the virus)
  • capsid
  • single stranded RNA
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6
Q

Is the RNA single or double stranded in the Hep A virus ?

A

Single stranded = SSRNA

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7
Q

Is Hep B an acute or chronic infection ?

A

Both

  • starts acute
  • can stay in liver and cause damage to liver cells for >6months
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8
Q

How is Hep B transmitted ?

A
  • blood
  • sex
  • perinatal (to the foetus in utero)
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9
Q

What is the structure of Hep B virus like ?

A
  • has an envelope (phospholipid bilayer)
  • capsid
  • partially double stranded DNA
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10
Q

Is the RNA single or double stranded in the Hep B virus ?

A

partially double stranded

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11
Q

Is Hep C an acute or chronic infection ?

A

Both

  • starts acute
  • can stay in liver and cause damage to liver cells for >6months
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12
Q

How is Hep C transmitted ?

A
  • sex
  • blood
  • perinatal (to foetus in utero)
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13
Q

What is the structure of Hep C virus like ?

A
  • has an envelope (phospholipid bilayer)
  • capsid
  • single stranded RNA
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14
Q

Is Hep D an acute or chronic infection ?

A

mainly a chronic infection

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15
Q

How is Hep D transmitted ?

A
  • sex
  • blood
  • perinatal (to foetus in utero)
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16
Q

What is different about how Hep D infects the host ?

A

Hep D relies on Hep B

CO-INFECTION = Hep B and D infect at same time
SUPERINFECTION = Hep B infects, Hep D infects later

17
Q

What are the 2 mechanisms of infection via Hep D ?

A
  • co-infection (Hep B and D infect at same time)
  • superinfection (Hep B infects first, Hep D infects later)
18
Q

What is the structure of Hep D virus like ?

A
  • has an envelope
  • capsid
  • circular single stranded RNA
19
Q

Is a Hep E infection acute or chronic ?

A

mainly acute
can cause chronic but it is not very common

20
Q

How is Hep E transmitted ?

A

Fecal-oral route

= someone ingests faecal matter of an infected person

21
Q

What is the structure of Hep E virus like ?

A
  • no envelope
  • capsid
  • single stranded RNA
22
Q

Which is the only form of Hepatitis that contains DNA ?

A

Hep B

23
Q

How do the ssRNA hepatitises (A, C, D, E) replicate themselves within the host ?

A
  • uses host ribosomes for protein synthesis
  • synthesises viral proteins e.g capsomeres to make the capsid, antigens, polymerase etc
  • synthesised into new viruses by host golgi apparatus
  • synthesised RNA polymerase formulates new RNA strands that combine with the viral proteins to form new viruses
24
Q

How does the dsDNA hepatitis (Hep B) replicate itself within the host ?

A
  • viral DNA released into nucleus of cell
  • host RNA polymerase translates it into viral mRNA that leaves the nucleus
  • host ribosomes perform protein synthesis using the viral mRNA
  • synthesises viral proteins e.g capsomeres to make the capsid, antigens, polymerase etc
  • synthesised into vesicles by host golgi apparatus
  • synthesised viral RNA polymerase formulates new RNA strands
  • RNA converted to DNA by reverse transcriptase
  • vesicles and DNA combine to form new viruses
25
Q

What happens when new hepatitis viruses accumulate within the cell ?

A
  • death of the hepatocyte
26
Q

How does accumulation of hepatitis viruses within a cell cause cell death ?

A
  1. Overload = Lysis
    = accumulation causes lysis of the cell
  2. Immune Response
    = viral proteins interact with MHC-1 receptors on cell surface
    = triggers Tcell response (CD8 Tcells)
    = they recognise foreign antigen (viral protein)
    = release perforins that perforate the cell membrane
    = release granzymes that enter via perforations and trigger apoptosis
27
Q

What do damaged hepatocytes secrete ?

A

Interferon Gamma (INF-γ)

= activates macrophages

28
Q

What type of cell does INF-γ activate in response to heptocyte cell death ? What does this cell type do ?

A

INF-γ activates macrophages that stimulate CD8 Tcells to kill the infected cell

Sem 4, case 5 (hepatitis) (3 decks)

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