Viral Hepatitis

Question 1

Which viral species are usually reponsible for hepatitis?

Answer 1

Hep A
Hep B
Hep C
Hep D
Hep E

Question 2

Rare causitive viruses of hepatitis are?

Answer 2

Adenovirus, coxsackle virus,, cytomegalovirus, epstein-barr virus, parvovirus B19 and rare cases of herpes simplex virus and varicella zoster virus

Question 3

Most common Hep viruses in Canada & globabally

Answer 3

A, B, C

Question 4

RNA Hepatitius viruses?

Answer 4

HAV, HCV, HDV, HEV

Essentially everything other then HBV

Question 5

DNA hepatitus viruses?

Answer 5

Just HBV

Question 6

Transmission routes of HAV?

Answer 6

Fecal-oral

sexual

Question 7

Transmission routes of HBV and HDV

Answer 7

Percutaneous, Sexual, Perinatal

Question 8

Transmission routes of HCV

Answer 8

Percutaneous, sexual, perinatal (rarer)

Question 9

Transmission routes of HDV

Answer 9

Fecal-oral, zoonotic (animal to human), parenteral, perinatal

Question 10

Which hepatitus viruses have vaccines avaliable?

Answer 10

HAV, HBV, HDV,

Question 11

When does an acute viral hepatitus progress to chronic?

Answer 11

when present for >6 months

Question 12

Most common causes of chronic hepatitis?

Answer 12

HCV,HBV

Question 13

Symptoms of acute hepatitis?

Answer 13

Fever, myalgias, arthralgias, headache, constant fatigue, malaise, right upper quadrant pain, jaundice, dark urine, clay-coloured stools, and tender hepatomegaly

Question 14

Lab findings indicative of acute hepatitis

Answer 14

Rise in serum aminotransferases (ALT>AST), atypical lyphocytosis (increase of peripheral blood lymphocytes usually >4000), and possible elevated immunoglobulin M levels

Question 15

Symptoms of acute liver failure

Answer 15

Prolonged INR, jaundice, and encephalopathy

Question 16

Lab marker that indicates an active HAV infection

Answer 16

Positive for anti-HAV IgM

Question 17

Biomarker for HBV infection

Answer 17

positive for HBsAg (surface antigen)

Question 18

Biomarker for HCV infection

Answer 18

Anti-HCV
BUT may be negative for first 6 weeks of exposure

HCVRNA by PCR indicates HCV replication activity and appears at start of acute infection

Question 18

Biomarker for HCV infection

Answer 18

Anti-HCV
BUT may be negative for first 6 weeks of exposure

HCVRNA by PCR indicates HCV replication activity and appears at start of acute infection

Question 19

HDV biomarker

Answer 19

Anti-HDV

Question 20

HEV biomarker

Answer 20

Anti-HEV IgM indicates acute infection, lasts ~16 weeks

Anti-HEV IgG lasts years

Question 21

Difference in lethality of HEV in normal and pregant patients

Answer 21

HEV has low mortality in normal patients (1-3%) but increases to ~25% in pregant patients (pregnant patients, fetal and neonatal)

Question 22

Antiviral options in HBV

Answer 22

Tenofovir, tenofovir alafenamide, entecavir

Question 23

Which hepatitis viruses have vaccinations avaliable

Answer 23

HAV, HBV

BUT HBV vaccine gives immunity to HDV as well

Question 24

Immigrants might benefit from which hep vaccine?

Answer 24

HBV when coming from endemic areas

Question 25

How to lower risk of Parent-child transmission of HBV?

Answer 25

immunization with HBV immune globulin and HBV vaccine

Also can use lamivudine, telbivudine and tenofovir 28 weeks gestation and 1 month postpartum to reduce transmission risk

Question 26

Tenofovir vs lamivudine vs telbivudine in HBV prophylaxis parent to child

Answer 26

Tenofovir has better efficacy and higher genetic barrier to viral resistance