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Microbio > Viral GI I > Flashcards

Viral GI I Flashcards

1
Q

What is the color of the stool in hepatitis? Urine color?

A

Gray stool (acholic)

Dark urine

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2
Q

What is hepatitis?

A

Liver inflammation

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3
Q

What are the three types of hepatitis?

A
  1. Acute
  2. Chronic
  3. Filminant
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4
Q

What is the prodrome of hepatitis? When do these present?

A

HA, myalgias, arthralias, n/v mild fever 1-2 weeks prior

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5
Q

What causes the gray stool of hepatitis (acholic stool)?

A

Loss of heme in it

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6
Q

What causes the jaundice and scleral icterus caused by acute hepatitis?

A

Increased bilirubin

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7
Q

Why is there an increase bili in hepatitis?

A

Lower liver conjugation of bili from biliverdin

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8
Q

What are the levels of bili in hepatitis jaundice?

A

> 3 ml/dl

commonly 5- 20 ml/dL

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9
Q

What is bilirubin in urine indicative of?

A

Liver disease

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10
Q

What are the LFTs that are elevated in viral hepatitis?

A

ALT

AST

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11
Q

Which has higher LFTs, viral or other causes of hepatitis?

A

Viral

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12
Q

What is chronic viral hepatitis?

A

Hepatitis that does not resolve within 6 months

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13
Q

What is the problem with chronic hepatitis (what does it cause)?

A

Predisposes individual to hepatocellular carcinoma and/or cirrhosis

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14
Q

How long does hepatocellular carcinoma take to develop in chronic viral hepatitis?

A

15-40 years

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15
Q

What is the cause of developing cirrhosis of the liver in hepatitis?

A

Immune response

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16
Q

What causes the liver CA in chronic viral hepatitis?

A

Constant regrowth of hepatocytes after damage

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17
Q

Will breast CA that metastasizes to the liver function the same way to cause liver CA as hepatocellular carcinoma caused by hepatitis?

A

No

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18
Q

What happens to the liver between chronic hepatitis and the development of HCC?

A

Cirrhosis

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19
Q

What is the most severe form of viral hepatitis?

A

Fulminant hep

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20
Q

What happens in fulminant hep?

A

Rapid, severe necrotic hepatitis that can lead to encephalopathy

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21
Q

What are the complications of fulminant viral hepatitis?

A 
Cerebral edema
Brainstem compression
GI bleeding
Sepsis
Organ failure
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22
Q

How can you help someone with fulminant Hep?

A

Liver transplant

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23
Q

What are the five types of hepatitis?

A

A - E

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24
Q

What are the two hepatitis viruses that are transmitted through the fecal-oral route?

A

A and E

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25
Q

What are the three hepatitis viruses that can cause chronic hep infections?

A

B- D

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26
Q

Is there a vaccine for hep A?

A

Yes

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27
Q

What are the symptoms of hep A? How long do these usually last?

A

Abdominal pain, n/v/d

> 2 months

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28
Q

How do you diagnose acute hep A infx?

A

IgM antibodies for HAV

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29
Q

What family of viruses is hep A from? genome type?

A

Picornavirus

+ ssRNA

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30
Q

Are children usually symptomatic with Hep a infx?

A

No

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31
Q

Does hep A cause chronic hep? Fulminant?

A

No chronic,

Fulminant, rarely

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32
Q

What is the antibody seen in acute hep a infx? What antibody provides long term immunity?

A

IgM for acute

IgG for immune

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33
Q

How is the Hepatitis vaccine given? How many times?

A

IM x2

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34
Q

What is the age range for Hepatitis A vaccine?

A

12-23 mo

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35
Q

What is the post-exposure prophylaxis for hep A? When is this used?

A

Preformed anti-HAV IgG and vaccine

Used in high risk populations

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36
Q

What is the prevalence of Hep a in the US?

A

about a 1/3 infected

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37
Q

What is the prevalence of Hep B in the US?

A

5%

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38
Q

What do complete virion particles of Hep B look like under the scanning EM? What are they called?

A

Circle called Dane particles

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39
Q

What are the tubes and spheres that are seen around complete Hep B molecules in a scanning EM?

A

incomplete, noninfectious forms of Hep B

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40
Q

What is the family of Hep B? Genome?

A

Hepadnavirus family

dsDNA

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41
Q

What enzyme is needed for Hep B to replicated, and serves as a drug target?

A

Reverse transcriptase

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42
Q

What is the surface antigen for Hep B? Is this soluble? What is this seen on (dane particles or tubules?

A

HBsAg
Soluble
Seen in both tubules and dane particles

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43
Q

What is the core antigen for Hep B? Is this soluble/detected in the serum?

A

HBcAg

Not soluble, therefore not detected in the serum (antibodies are though)

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44
Q

What is the Hep B antigen associated with DNA? Is this soluble/found in serum?

A

HBeAg

Soluble, thus found in serum

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45
Q

How long does HBsAg last in acute vs chronic infections?

A

Acute = peaks and disappears

Chronic, stays high

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46
Q

How long does HBsAg antibody last in acute vs chronic infections?

A

Acute = peaks after HBsAg peak

Chronic, stays high

47
Q

How long does ALT stay elevated in chronic vs acute HBV?

A

Acute = short time

Chronic = throughout infx

48
Q

What is the mode of transmission for Hep B?

A

Sexual transmission or perinatal

49
Q

What percent of HBV infections result in chronic infections? What is this correlated with?

A

5%, decreasing with age

50
Q

How many adults are asymptomatic with Hep B?

A

50%

51
Q

The younger you are the (blank) likely you are of developing a chronic Hep B infx?

A

The younger you are the MORE likely you are of developing a chronic Hep B infx?

52
Q

What is the treatment for acute infx of Hep B? Chronic?

A

Acute = none

Chronic = Lamivudine or famcyclovir/adefovir

53
Q

What is the MOA of lamivudine that treats Hep B?

A

Reverse transcriptase inhibitor

54
Q

What is the MOA of famcyclovir/adefovir nucloside for Hep B?

A

Nucloside inhibitor

55
Q

What is the vaccine for Hep B made of?

A

Recombinant HBV vaccine produced in yeast

56
Q

When is the Hep B vaccine given?

A

Soon after delivery, but 3 total doses

57
Q

What are the three tests that can be performed to diagnose Hep B on blood donations?

A

Surface antigen
B core antibody
ALT

58
Q

What is the prevalence of Hep C in the US?

A

2% infected

59
Q

Does Hep C cause chronic hepatitis?

A

yes

60
Q

Does Hep B cause chronic hepatitis? D?

A

Yes

61
Q

Does Hep A cause chronic hep? E?

A

No

62
Q

What is the family that Hep C belongs to? Enveloped? Genome?

A

Flavivirus
Enveloped
+ssRNA

63
Q

How is Hep C usually transmitted?

A

Injection drug use

64
Q

How do you screen for Hep C?

A

Antibody based test for Anti HCV antibodies

65
Q

How do you confirm Hep C?

A

Nucleic acid based tests for detection of the viral genome

66
Q

Are the acute symptoms of Hep C more severe or milder than A and B?

A

Milder

67
Q

What is the chance that Hep C develops into chronic infx?

A

70%

68
Q

What is the MOA of Sofosbuvir (treatment for Hep C)?

A

RNA dependent RNA polymerase inhibitor

69
Q

What is the main viral drug that treats Hep C? What does this depend on?

A

Sofobuvir, but depends on the genotype of Hep C

70
Q

Is there a vaccine available for Hep C?

A

No

71
Q

How can you prevent Hep C infx?

A

Reduce IV drug use
Protected sex
Screen blood supply

72
Q

What is the test for Hep C (what is it looking for)?

A

Looking for Hep C anti-HCV

73
Q

What is the morphology and genome type of Hep D?

A

small, circular ssRNA

74
Q

What does Hep D need to survive?

A

Needs Hep B virus to place surface antigens

75
Q

What is the exterior surface of Hep D? What is the consequence of this?

A

Hep B surface antigen

Means that this can only infect cells that have Hep B antigen on cell surface

76
Q

Who is at risk of Hep D?

A

People who have been previously infected of Hep B or are currently

77
Q

What is the only Hep virus that directly damages that liver?

A

Hep D

78
Q

How do you diagnose Hep D?

A

ELISA

79
Q

What is the treatment for Hep D?

A

No specific antiviral treatment

80
Q

How do you prevent Hep D infx?

A

Vaccinate against Hep B

81
Q

What is the Hep E virus family? Genome?

A

Hepevirus

+ssRNA

82
Q

What is the route of transmission for Hep E?

A

Fecal-oral route

83
Q

Who is usually infected with Hep E?

A

Travelers

84
Q

Who is at high risk of death from Hep E?

A

Pregnant women

85
Q

Is there a vaccine for Hep E?

A

No

86
Q

What is the treatment for Hep E?

A

Supportive

87
Q

What is the virus family for Hep D?

A

Deltavirus

88
Q

What is the virus family for Hep B?

A

Hepadnavirus

89
Q

How long does it take for Hep A to resolve?

A

2 months

90
Q

What percent of neonates born to HBV + mothers get chronic HBV?

A

90%

91
Q

What is the chance that HBV will develop into hepatitis (note, NOT chronic; fulminant)

A

1-2%

92
Q

True or false: Detecting HBsAg in the blood means that there is an acute or chronic infection aking place

A

True

93
Q

Anti-HBcAg

antibodies are used as a marker of what?

A

a current or

previous infection with HBV

94
Q

Are anti-HBcAg

IgM antibodies detected in acute or chronically infected patients? Are these observed in immunize people?

A

Acute (will switch to IgG)

Not in immunized people

95
Q

What is the treatment for acute HBV infx?

A

Supportive

96
Q

When is the first dose of Hep B vaccine given?

A

Prior to hospital discharge

97
Q

What does the Hep B vaccine contain?

A

Recombinant protein from Hep B

98
Q

Premature infants born to mothers of unknown or positive HBsAg status should receive the vaccine and HBIG within how many hours of birth?

A

12 hours

99
Q

For how long does the HbeAg antigen last in an acute and chronic Hep B infx? What happens after this disappears?

A

Only for acute phase, then turns to antibody for it

[NOTE that it lasts longer in chronic, but still goes away after some time]

100
Q

Can you see HBV DNA in acute infx?

A

No, just chronic

101
Q

When is the antibody for HBV core antigen produced in acute vs chronic infections?

A

Acute comes on after HBsAg disappears

Chronic, always there

102
Q

For an acute infection with HBV, which of the four antigens/antibodies will you detect? (give answer in numbers)

  1. HBsAg
  2. antiHBsAG
  3. total antiHBc IgM
  4. antiHBc IgM)
A

1, 3, 4

103
Q

For a chronic infection with HBV, which of the four antigens/antibodies will you detect? (give answer in numbers)

  1. HBsAg
  2. antiHBsAG
  3. total antiHBc IgM
  4. antiHBc IgM)
A

1, 3

104
Q

For vaccination against HBV, which of the four antigens/antibodies will you detect? (give answer in numbers)

  1. HBsAg
  2. antiHBsAG
  3. total antiHBc IgM
  4. antiHBc IgM)
A

2

105
Q

For a previous infection with HBV, which of the four antigens/antibodies will you detect? (give answer in numbers)

  1. HBsAg
  2. antiHBsAG
  3. total antiHBc IgM
  4. antiHBc IgM)
A

2, 3

106
Q

For a person susceptible to HBV, which of the four antigens/antibodies will you detect? (give answer in numbers)

  1. HBsAg
  2. antiHBsAG
  3. total antiHBc IgM
  4. antiHBc IgM)
A

None

107
Q

What type of hepatitis infection is more likely to occur with coinfection of Hep B and D?

A

Fulminant

108
Q

Hep D infection is considered a what type of infection?

A

Superinfection

109
Q

Which immune cell specifically, causes liver damage in hepatitis?

A

CTLs

110
Q

What is the “window period” of acute hepatitis B?

A

Time between HBsAg in the serum, and its antibody

111
Q

What is the difference between chronic replicative hep B and chronic non-replicative?

A

Replicative = HBeAg is present

Non-replicative = not present

[recall that e is for the DNA component of Hep B]

112
Q

What percent of adults who contract HBV will progress to a chronic infection? How about for neonates?

A

10% for adults

90% for neonates

113
Q

If all you see in a hep infection is antibody, is the pt still infected?

A

No

114
Q

Why is a superinfection with Hep D and Hep worse than coinfection?

A

Already has Hep B surface antigen

Microbio (50 decks)

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