Primer 28 - Hepatitis

Question 1

What is the genetic structure of Hepatitis A virus?

Answer 1

Single Stranded RNA virus.

Question 2

How is Hepatitis A transmitted?

Answer 2

Fecal-oral route.

Question 3

How is Hepatitis E transmitted?

Answer 3

Fecal-oral route.

Question 4

Is there a carrier state for Hepatitis A?

Answer 4

No.

Question 5

What is the incubation period for Hepatitis A?

Answer 5

2 weeks.

Question 6

What outstanding fact is associated with Hepatitis E?

Answer 6

Very complicated or deadly in pregnant women.

Question 7

What is the genomic structure of Hepatitis D?

Answer 7

It is incomplete, or defective single stranded RNA. “Hep D for Defective”.

Question 8

What is unusual about Hepatitis D?

Answer 8

Cannot infect unless the patient already has Hepatitis B.

Question 9

What is the genomic structure of Hepatitis C?

Answer 9

Single stranded RNA.

Question 10

What is the most common way to transmitt Hepatitis C?

Answer 10

Parentally.

Question 11

How is Hepatitis C diagnosed?

Answer 11

Anti Hep C virus antibodies.

Question 12

What is the percentage of Hepatitis C becoming a chronic disease?

Answer 12

It is 80-90 percent.

Question 13

What risk is increased in carrier states of Hepatitis C?

Answer 13

Hepatocellular cancer.

Question 14

What is the treatment for Hepatitis C?

Answer 14

Interferon and ribavirin.

Question 15

What is the most common transfusion mediated hepatitis?

Answer 15

Hepatitis C.

Question 16

What is the genomic structure of Hepatitis B?

Answer 16

Double stranded DNA virus.

Question 17

What is the only hepatitis virus that has DNA?

Answer 17

Hepatitis B.

Question 18

What is the percentage of patients having a chronic hepatitis from hepatitis B infection?

Answer 18

It is 10 percent.

Question 19

What is the percentage of infants or immunocompromised patients developing chronic hepatitis for Hepatitis B?

Answer 19

It is 80-90%.

Question 20

What are the 6 big drugs to give to patients with Hepatitis B infection?

Answer 20

1. Interferon
2. Lamivudine
3. Adefovir
4. Entecavir
5. Telbivudine
6. Tenofovir

Question 21

What is a Dane particle?

Answer 21

An intact hepatitis B particle.

Question 22

What is the incubation time for hepatitis B?

Answer 22

It is 60 to 90 days.

Question 23

What do the following stand for?
HBsAg
HBsAb
HBcAb
HBeAg
HBeAb

Answer 23

HBsAg: Hepatitis B surface Antigen.
HBsAb: Hepatitis B surface Antibody.
HBcAb: Hepatitis B core Antibody.
HBeAg: Hepatitis B "E" antigen.
HbeAb: Hepatitis B "E" antibody.

Question 24

What does HBsAg being positive mean?

Answer 24

That there is active disease going on.

“Hepatitis B surface antigen are the bad guys.”

Question 25

What does HBsAb being positive mean?

Answer 25

It means that you do not have active disease. It can mean two things: Either you have had the disease before (and recovered) or have been immunized by vaccination. "Hepatitis B surface antibody are the Good Guys."

Question 26

What does HBcAb being positive mean?

Answer 26

It means two things: It will be +IgM for early acute infection and window period. It will be +IgG for Chronic infection or complete recovery.

Question 27

What does HBeAg being positive mean?

Answer 27

That the virus is actively replicating, which indicates a high transmissibility.

Question 28

What does HBeAb being positive mean?

Answer 28

That there is going to be a low transmisibility.

Question 29

What is the first particle to be elevated in Hepatitis B infection?

Answer 29

HBsAg. | Hepatitis B surface Antigen.

Question 30

What is the window period in Hepatitis B?

Answer 30

HBsAg rises about a month after exposure and then after 5 and a half months later, it goes down. Two weeks later the HBsAb finally begins to rise. The two week period when both HBsAg and HBsAb are low/absent is called the window period.

Question 31

``` What does this indicate? HBsAg: + HBsAb: - HBcAb: +IgM HBeAg: + HBeAb: - ```

Answer 31

Early Acute Infection.

Question 32

``` What does this indicate? HBsAg: - HBsAb: - HBcAb:+IgM HBeAg: +/- HBeAb: +/- ```

Answer 32

Window period.

Question 33

``` What does this indicate? HBsAg: + HBsAb: - HBcAb: +IgG HBeAg: + HBeAb: - ```

Answer 33

Chronic Infection with HIGH transmitability.

Question 34

``` What does this indicate? HBsAg: + HBsAb: - HBcAb: +IgG HBeAg: - HBeAb: + ```

Answer 34

Chronic Infection LOW transmisibility.

Question 35

``` What does this indicate? HBsAg: - HBsAb: + HBcAb: +IgG HBeAg: - HBeAb: + ```

Answer 35

Past Infection and fully recovered.

Question 36

``` What does this indicate? HBsAg: - HBsAb: + HBcAb: - HBeAg: - HBeAb: - ```

Answer 36

Vaccinated.

Question 37

What is an accompanying feature of autoimmune hepatitis?

Answer 37

A lot of patients have other types of autoimmune disease such as type I Diabetes, hemolytic anemia, autoimmune thyroiditis, ulcerative colitis.

Question 38

What medications are used in the treatment of chronic hepatitis B and C?

Answer 38

Interferon alpha: Chronic hepatitis B and C | Ribavirin: Chronic hepatitis C

Question 39

Which antibodies can be used to help make the diagnosis of autoimmune hepatitis?

Answer 39

1. ANA (+), Anti-smooth muscle Ab (+) 2. Anti-liver-kidney microsomal Ab (+) 3. Anti-mitochondrial Ab (-)

Question 40

What antibodies indicate Type I autoimmune hepatitis?

Answer 40

ANA (+) and/or anti-smooth muscle antibody (+).

Question 41

What antibodies indicate Type II autoimmune hepatitis?

Answer 41

Liver/Kidney microsomal antibody (+) and/or liver cytosol antigen (+).

Question 42

What is good lab finding to tell the difference between alcohol induced hepatitis versus a viral induced hepatitis?

Answer 42

AST is higher than ALT in alcohol induced hepatitis. "A Scotch and Tonic". ALT will be equal or higher than AST in viral induced hepatitis.