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Block 4 Found Sci > VI- Viral Hepatitis > Flashcards

VI- Viral Hepatitis Flashcards

1
Q

acute hepatitis presentation

A
  1. jaundice
  2. dark urine
  3. acholic stool (light or clay colored)
  4. prodrome- headache, myalgia, arthralgia, fatigue, nausea, vomit, pharyngitis, fever
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2
Q

acute hepatitis lab values

A
  1. bilirubin > 3, typically b/t 5-20
  2. ALT and AST
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3
Q

chronic hepatitis definition

A

hepatitis that doesn’t resolve in 6 mo
-predisposes to liver cirrhosis and hepatocellular carcinoma

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4
Q

fulminant hepatitis presentation

A
  1. rapid, severe hepatitis
  2. massive hepatic necrosis
  3. encephalopathy
  4. edema
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5
Q

complications of fulminant hepatitis

A
  1. cerebral edema
  2. brainstem compression
  3. GI bleeding
  4. sepsis
  5. organ failure
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6
Q

Hep A features

A
  1. picornavirus +ssRNA
  2. incubation 2-4 weeks
  3. fecal oral transmission
  4. no chronic infection
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7
Q

Hep B features

A
  1. hepadnavirus dsDNA
  2. 6 week - 6 m incubation
  3. body fluid transmission
  4. yes develop to chronic
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8
Q

Hep C features

A
  1. flavivirus- enveloped +ssRNA
  2. 2 mo incubation
  3. body fluid transmissin- esp injection drugs
  4. yes chronic infection
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9
Q

Hep D features

A
  1. deltavirus
  2. 2-12 week incubatin
  3. body fluid transmissin
  4. yes chronic
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10
Q

Hep E features

A
  1. hepevirus +ssRNA
  2. 6-8 week incubation
  3. fecal oral transmission
  4. no chronic
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11
Q

Hep A diagnosis

A
  1. acute infection has IgM Ab
  2. anti HAV IgG for protective immunity
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12
Q

Hep A outcomes

A
  1. resolution within 2 mo
  2. rarely causes fulminant

og symps usually asymptomatic all age groups

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13
Q

HAV vaccine

A

-2 doses of inactivated whole virus IM injection
-all kids at 1 should get
-high risk groups include homosex men, travelers, illegal drug users, clotting factor disorders, close contact with international adoptee, occupation

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14
Q

Hep B histology

A
  1. dane particles aka complete virions infectious with HBeAg, HBcAg, HBsAg
  2. tubes and spheres of incomplete noninfectious particles coated by HBsAg
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15
Q

acute HBV antibodies if cleared

A
  1. initial rise in IgM anti-HBc
  2. isotype switch to IgG anti-HBc

will have anti-HBs (surface)

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16
Q

acute HBV antibodies if chronic

A
  1. rise and decline of IgM anti-HBc
  2. anti-HBc (core) instead of surface like clearance
17
Q

Hep B outcomes

A
  1. half are asymptomatic
  2. if symps then milder than HAV acute hepatitis
18
Q

Hep B chronic treatments

A
  1. oral polymerase inhibitors - lamivudine (nucleoside reverse transcriptase inhib) and tenofovir disoproxil fumarate (acyclic nucleotide analogue polymerase inhib)
  2. cell intrinsic immune modulator - pegylated interferon (long acting interferon bound to polyethelene glycol) injected
19
Q

HBV vaccine

A

-protein vaccine with HBsAg
-IM injection 3 doses for routine vaccination kids or pre exposure high risk adults

20
Q

groups for post exposure prophylaxis HBV

A
  1. premature infants with mothers HBsAg pos or unknown status
  2. full term infant with HBsAg pos mother
  3. percutaneous expsoure of health care workers

combo of vaccine + Hep B immunoglobulin

21
Q

HCV processing

A
  1. HCV virion
  2. +ssRNA genome translated
  3. immature viral polyprotein proteolysed by HCV NS3/4A
  4. mature viral proteins replicated by HCV NS5B RdRp and HCV NS5A
  5. -ssRNA
  6. virion assembly by HCV NS5A
22
Q

Hep C testing guidelines

A

one time for: all indivs 18+, under 18 if inc risk, prenatal care
periodic for: inc risk exposure groups
annual for: injection drug users, HIV infected men, men taking pre-exposure prophylaxis

23
Q

HCV diagnosis

A
  1. screening test for anti-HCV antibodies
  2. confirmatory test for detection of viral genome
24
Q

Hep C outcomes

A

majority develop to chronic, some acute but symps milder than HAV or HBV,
-some rapid progress to cirrhosis

25
Q

HCV treatments

A

-combo therapy with direct acting antivirals for 12-24 weeks, no vaccine
-can simplify if chronic without cirrhosis and not previously received treatment
-recommended for all patients acute or chronic

26
Q

HCV antivirals

A
  1. protease inhibitors - glecaprevir, prevents cleavage to mature protein
  2. RNA polymerase inhibitors - sofosbuvir, prevents genome rep
  3. HCV HS5A inhibitors - pribentasvir, velpatasvir, stops replication and virion assembly
27
Q

Hep D structure

A

small circular ssRNA
-two proteins cover virions (delta short and delta long)
-helper dependent bc needs Hep B surface antigen to form external surface AND replication requires HBV proteins

28
Q

HDV outcomes

A

fulminant hepatitis more likely outcome if double infected with B and D
-directly injures hepatocytes instead of immune resp

29
Q

HDV diagnosis

A
  1. elisa to detect anti-HDV antibodies or delta antigens
  2. no specific treatments
  3. prevent by HBV vaccine
30
Q

Hep E treatment

A
  1. alleviate symptoms
  2. prevent by clean water and proper food handling

Block 4 Found Sci (67 decks)

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