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Micro B4 > Pg 15 - 19 > Flashcards

Pg 15 - 19 Flashcards

1
Q

A general term used to indicate an infection of the liver caused by one of several major distinct viral agents. Symptoms, which vary in severity and are not specific to the causative agent, include: Anorexia and weight loss; Hepatic tenderness; Jaundice and dark urine.

A

Viral Hepatitis

NOTE: Hepatitis viruses are not taxonomically related to each other.

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2
Q

Surface Antigen (HBsAg)

Viral structure – Enveloped, DNA virus

A

Hepatitis B (HBV)

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3
Q

Core – DNA and DNA polymerase
• Hepatitis __ Core Antigen (HBcAg)

• Hepatitis __ “e” Antigen (HBeAg) (“e” antigen of the core) – presence is associated with relatively high infectivity

A

Hepatitis B (HBV)

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4
Q

Presence of what antigen for Hep B is associated with high infectivity?

A

“e” Antigen (HBeAg)

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5
Q

(a) Transmission - parenteral route most predominant mode. Contact with blood or blood products, usually via contaminated needles or syringes.
(b) High risk groups
• Intravenous drug users; male homosexuals
• Patients with multiple transfusions; Hemophiliacs; Dialysis
(c) Incubation period
• Usually 45 to 180 days
• Replicates in liver

A

Hepatitis B (HBV) transmission

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6
Q

Hepatitis B (HBV) transmission?

A

parenteral route most predominant mode (Contact with blood or blood products, usually via contaminated needles or syringes)

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7
Q

Hep B high risk groups?

A

IV drug users

male homosexuals

patients with multiple transfusions

hemophiliacs

dialysis

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8
Q

Important antigens for Hep B labwork?

A

HBsAg

HBeAg

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9
Q

Earliest marker of acute infection; indicates infectious state
• Persistence over 6 months implies chronic disease (failure to seroconvert to anti-HBs)

A

HBsAg (i.e. Hepatitis B Surface Antigen)

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10
Q
  • Early indicator of acute infection, active virus replication, and most infectious period
  • Persistence beyond 10 weeks indicative of progression to chronic carrier state and probable chronic liver damage

(Note that this isn’t the EARLIEST indicator)

A

HBeAg (core-associated “e” antigen)

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11
Q
  • Seroconversion from HBeAg to anti-HBe usually occurs during late acute phase - suggests resolution of infection and lowering of transmissibility
  • Chronic/carriers fail to seroconvert during acute phase
A

Anti-HBe (antibody to Hepatitis B “e” antigen of the core)

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12
Q
  • Appears during convalescence – indicates recovery and immunity
  • Major protective antibody against HBV (also develops from vaccination)
  • Failure to seroconvert indicative of chronic infection
A

Anti-HBs (antibody to Hepatitis B surface antigen)

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13
Q

Acute Hep B infection - viral hepatitis that resolves within?

A

3-6 months

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14
Q

Hep B infection chronic/chronic carrier infection timelines?

A

May last for several months to decades with or without symptoms

Infection may progress with continued active secretion of HBsAg in the absence of apparent active viral replication

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15
Q

HBV vaccine?

A

Active, long term immunity (anti-HBs) (85-95% success)

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16
Q

As we see the Hep B antigens go down, we hope

A

the AB go up (active immune response, right?)

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17
Q

If Hep B antibody count goes up, and the HB antigens goes down,

A

we can assume the patient is in the process is being cured.

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18
Q

If antibody response (as can be seen in labwork) is not robust enough, the Hep B antigens will proliferate, likely leading to ____ infection

THINK ABOUT THE GRAPHS MENTIONED

A

chronic

19
Q

Hep B is DNA virus, Hep C is?

A

RNA

20
Q

Viral structure – Small, lipid-enveloped RNA virus

Transmission - parenteral route

A

Hepatitis C (HCV)

21
Q

Disease state/stages very similar to Hepatitis B

(a) Accounts for 15-40% of community acquired hepatitis; increased in IV drug users;
(b) High co-infection with HIV

A

Hepatitis C (HCV)

REVIEW HEP B course of infection to refresh

22
Q

Vaccine for Hep C?

A

Negative ghost rider (too many antigenic subtypes)

23
Q

Structure – Small, nonenveloped, RNA virus – Capsid protein (HA Ag)

A

Hepatitis A – genus Hepatovirus

24
Q

(a) Transmission – fecal-oral route (enteric route) (primarily via food and water)
(b) High risk groups: Institutionalized persons, Children in day care centers, World travelers, Military, Drug addicts

A

Hepatitis A – genus Hepatovirus

25
Q

(a) Incubation period - 15 to 45 days
(b) Replicates within liver and small intestines
(c) Blood and feces are infectious during 2-6 week incubation and early illness period – No chronic state or carrier state

A

Hepatitis A – genus Hepatovirus

26
Q

No chronic or carrier state?

A

Hepatitis A – genus Hepatovirus

27
Q

Prophylaxis and treatment for Hep A?

A

Vaccine or immune serum globulin

28
Q

(a) Bunyaviridae – Hantaviruses, Crimean-Congo Hemorrhagic Fever, Rift Valley Fever
(b) Filoviridae family - Ebola & Marburg
(c) Flaviviridae family - Dengue, Yellow Fever, West Nile, Zika, others
(d) Togaviridae family, Alphavirus genus - Chikungunya

A

Hemorrhagic Fever Viruses

29
Q

(2) Contagious — MODERATE
(3) Incubation period 4-21 days
(4) Duration of illness: 5-16 days
(5) Mortality variable (10 to 90%)

A

Hemorrhagic Fever Viruses

30
Q

Hemorrhagic fever viruses? (Common names)

A

Crimean-Congo Hemorrhagic Fever
Rift Valley Fever, Hantavirus

Ebola & Marburg

Dengue, Yellow Fever, West Nile, Zika, others

Chikungunya

31
Q

(a) Moderately Frequent: Northern Asia, Europe (>150K/year; 2-40% mortality)
(b) Transmitted via inhaled rodent excreta

A

Hemorrhagic Fever with Renal Syndrome (HFRS) (Hantaan, Seoul, Puumula viruses)

(hantavirus)

32
Q

(a) Very Infrequent: North America

(b) Transmitted via inhaled rodent excreta

A

Hantavirus Pulmonary Syndrome (HPS) (Sin Nombre virus)

33
Q

(b) Transmitted via inhaled rodent excreta

A

Hemorrhagic Fever with Renal Syndrome (HFRS) (Hantaan, Seoul, Puumula viruses)

Hantavirus Pulmonary Syndrome (HPS) (Sin Nombre virus)

34
Q

Fever, severe joint pain (“Breakbone Fever”), conjunctivitis, headache

Hemorrhagic fever form (lower frequency) – severe illness

(1) Frequent: Tropical & semi-tropical (50K-1M cases/year; DHF 3% mortality; very infrequent in USA)
(2) Transmitted by Mosquitoes

A

Dengue Virus; Dengue Hemorrhagic Fever – (4 types)

35
Q

(1) Moderately Frequent: Tropical Africa, Amazon basin (200K cases/year; 30K deaths)
(2) Transmitted by Mosquitoes

A

Yellow Fever Virus

36
Q

(1) Moderately Frequent: Africa, SE Asia, South & Central America (1M cases; 3K in W.Hemisphere, ~30 in USA; very low mortality)
(2) Transmitted by Mosquitoes
(3) Illness: Dengue-like symptoms; hemorrhagic form rare

A

Chikungunya virus

similar SSx to Dengue – hard to tell apart

37
Q

(1) Zoonotic in Africa; Infrequent in humans

(2) Transmitted by mosquitoes

A

Rift Valley Fever virus (RVF)

38
Q

(1) Infrequent: Africa, Middle East (to West China)

(2) Transmitted via ticks

A

Congo-Crimean Hemorrhagic Fever Virus (CCHF)

39
Q

(1) Moderately Frequent: West Africa (300-500K cases, 5K deaths)
(2) Transmitted via rodent excreta (urine)

A

Lassa Fever Virus

40
Q

(1) Infrequent: West & Central Africa (tens to thousands per year; ~35% deaths)
(2) Vector/reservoir
(a) Fruit bats & bush meat -> animals, human contact
(b) Transmission: direct contact with blood or body fluids
• At-Risk Areas: mucosal tissue, eyes, breaks in skin
• Aerosolization may deposit infectious droplets on at-risk tissues, but no aerosol transmission to respiratory tract
• Superspreaders: 3% of infected persons spread disease to 60+% of victims

(3) Incubation: up to 21 days (?)
(4) Contagious: from day of first symptoms (?) until no virus in blood (semen harbors for 3 months)
(5) Vaccine – in use in Africa (live Vesicular Stomatitis virus with gene for Ebola surface protein)

A

Ebola Hemorrhagic Fever virus (Marburg virus is similar)

41
Q

(a) Sudden onset fever, intense weakness, muscle pain, headache, sore throat
(b) Vomiting, diarrhea, rash, internal & external bleeding
(c) Acute fever, Flu-like symptoms, muscle aches, rash/erythema/petechiae
(d) Hemorrhage / Capillary leakage (vascular permeability, abnormal blood clotting) -> Shock

A

Ebola Hemorrhagic Fever virus (Marburg virus is similar)

42
Q

Differentiate Ebola from?

A

Malaria, Lassa Fever Virus, Typhoid, other VHF

43
Q

What type of long-term effects would you expect to see from an Ebola survivor?

A

chronic fatigue, headache, muscle/joint pain, memory loss, eye pain/blurry vision/sensitivity, hearing loss

Micro B4 (13 decks)

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