Sketchy: Hep B Flashcards
Cue:
- blue and other cool color scheme
DNA virus
Name the single stranded DNA virus.
parvovirus
About _____% of adult HBV cases will develop into a chronic infection.
5-10%
Describe the HDV genome.
negative sense, enveloped, circular RNA virus
Newborns with HBV have a _____% chance of developing a chronic infection.
90-95%
_______ is when both HepB and HepD are transmitted simultaneously.
Co-infection
Most DNA viruses replicate in the _____.
nucleus
Polyarteritis nodosa can affect the BVs leading to the kidney, which would manifest as _____ and ______.
a reduced GFR and HTN
Cue:
- hippies wearing oversized, flowy clothing sitting in a circle, with another half circle behind them
- loose clothing = enveloped virus
- circle = circular DNA
- half circle = partially double-stranded
Cue:
- mother hippie attaching pieces of flair to the orange-clad hippie children
- orange kids = Hepatitis D
- pieces of flair = HBsAg (HBV surface antigen)
Cue:
- fortune teller reading “Reverso Transcription” book and flipping a crab tarot card on a liver-shaped rock
- “reverso transcriptum” = uses reverse transcriptase
- rock liver = cirrhosis
- crab card = CA (hepatocellular carcinoma)
Does HBV cross the placenta? Why/why not?
No- it’s too large
Cue:
- hippie van has antenna twisted into an alpha shape
- twisted antenna = gets interference = interferon alpha = INF-alpha
Where does HBV replicate?
inside AND outside of the nucleus
Cue:
- Hippie covered in henna kneeling down next to kidney-shaped bead boxes, beading red beads onto a string
- Hippie = Hep B
- henna = rash
- kneeling = pain = arthralgias
- kidney shaped boxes = kidney damage
- ***all s/s of polyarteritis nodosa
Cue:
- father hippie with 2 hippie kids dressed in orange, flowy hippie clothes wearing moon necklaces and headbands
- Hepatitis D
- 2 kids = 2 types of infection (co-infection and superinfection)
- orange = RNA virus
- flowy clothes = enveloped
- moon = negative sense
- headbands = circle = circular genome
In ______, the small aneurisms that form on the arteries is said to have a “beads on a string” appearance.
polyarteritis nodosa
Cue:
- dome-shaped Hippie pad with hippies inside and outsidee
- dome shaped = nucleus
- Hippie pad = hepadnavirus
- out and in nucleus = replication occurs both places
What does HBV cause?
- hepatitis- RUQ pain, jaundic
- polyarteritis nodosa
- hepatocellular carcinoma
Most acute cases of HBV will _____.
resolve spontaneously
What is the tx for HBV?
- lamivudine
- NRTIs (nucleotide reverse transcriptase inhibitors)
- interferon alpha
Cue:
- baby has a large, liver-shaped cookie while the mom has a small cookie
- baby = 90-95% risk of chronic infection
- adult = 5-10% risk of chronic infection
A unique characteristic of the HBV genome is that it is _____-shaped and partially ______.
circular shaped, partially double stranded
If the pregnant mother is HBV positive, then give the newborn baby ______ and _____.
immunoglobulin and the HBV vaccine
HepD cannot cause any disease without ____.
HepB
Cue:
- one orange kid holding his dad’s hand, while one orange kid is sitting on the dad’s shoulders (and dad is grimacing)
- orange kid = HepD
- holding hand = cooperative = co-infection
- shoulders = superior position = super infection
- grimace = superinfection is worse
Describe the rash associated with HBV.
purpuric rash with non-blanching, dark macules
ALT is _____ in early neonatal hepatitis.
normal
ALT _____ in acute viral hepatitis.
rises
HDV requires ____ from HBV to be infectious.
Hep-B surface antigen
What does HBsAg mean?
Hepatitis B surface antigen
________ is when HepD is transmitted on top of existing HepB infection.
Superinfection
Does HBV carry its own reverse transcriptase?
yes- but it’s not a retrovirus bc it doesn’t integrate into the host chromosome
If a pt has positive serology for Anti-HBs, how do you know if they’ve just been vaccinated or if they have had a prior infection?
look for Anti-HBc and/or Anti-HBe
In ______ , ALT is greater than AST.
viral hepatitis
In alcoholic hepatitis, AST is _____ than ALT.
greater than
Cue:
- Hippie van with a flat tire that has wavy rainbow lines on the side that says “We are all one SpECiES”
- S = red E = orange C = yellow E = green S = blue
- Hippie van = hepatitis B
- flat tire under SPE = symptomatic beginning of infection S = HbSAg (HepB surface antigen) = first marker of active disease
- p = ignore
- E = HBeAg (HepB E antigen) = 2nd to appear; positive correlation to degree of infectivity
- C = anti-Hbc (HepB core antibody) = first Ab to appear in the window period
- i = ignore
- E = anti-HBe (HepB e antibody) = Ab to HepB E antigen = low infectivity
- S = anti-HBs (anti-HepB surface antibody) = infection over, pt has recovered
In viral hepatitis, AST is _____ than ALT.
smaller
Does HBV treatment cure the disease?
no, tx just minimizes damage by preventing replication
Cue:
- baby playing with a deflated beach ball labeled ALT and some keys shaped like IgG
- deflated ALT ball = ALT is normal in early neonatal hepatitis
- IgG keys = give at-risk babies immunoglobulins @ birth
In ______, AST is greater than ALT.
alcoholic hepatitis
In polyarteritis nodosa, the small aneurisms that form on the arteries is said to have a “______” appearance.
beads on a string
When does HBV become fully double-stranded?
during replication
_____ is a systemic vasculitis that affect medium to small arteries.
Polyarteritis nodosa
Cue:
- string with 2 knots in it going into a kidney box: big one on top with thick strings and one below with tram-track appearance
- knotted string = glomerulus
- top knot = thickened glomerular membrane of membranous glomerulonephritis
- bottom knot = mesangial deposits expanding into the BM in MPGN
Cue:
- Peace banner that reads “Make Peace, Not War” with a lamb and a she-elf on it
- some tx for HBV:
- lamb = lamivudine
- she-elf = NRTIs
____ and those pts with _____ HBV should be treated.
Pregnant women and chronic infection pts
If the pt is positive for Anti-HBs, do they have an acute or chronic infection?
neither- Anti-HBs = recovery or immunization
Cue:
- blue curve of second S in SpECiES is wrapped around a syringe
Anti-HBs is seen in vaccinated people
What kind of virus is Hep B?
enveloped DNA hepadnavirus
Cue:
- Hippie throwing a beach ball labeled ALT into the air
ALT rises in acute viral hepatitis
How is HBV transmitted?
- sex
- sharing blood products
- sharing needles
- vertical transmission
What will a person immunized against HBV test positive for on serology?
Anti-HBs
Cue:
- Hippie lady wearing red and white tye-dye, holding a sign that says “Sex, Drugs, and Rock and Roll,” pushing a baby, surrounded by tiki torches
- red and white = blood transmission
- sex/drugs/R&R = transmission
- baby = vertical transmission
- torches = O (other) in TORCHES
