Viral Hepatitis

Question 1

What type of Hepatitis?
a) Transmitted through consumption of contaminated water or
food, and fecal-oral route to include certain sex practices.
(b) Infections are typically mild and acute, with most making a
full recovery & gaining lifelong immunity.
(c) Most people in areas of the world with poor sanitation have
been infected with this virus.

Answer 1

Hepatitis A virus (HAV)

Question 2

What type of Hepatitis?
(a) Transmitted through exposure to infective blood, semen,
body fluids, contaminated blood products, and IV drug use.
(b) This poses risk to healthcare workers (needle stick injuries).

Answer 2

Hepatitis B virus (HBV)

Question 3

What type of Hepatitis?
Transmitted through exposure to infective blood,
contaminated blood & blood products, and IV drug use.
Sexual transmission is possible but less common.

Answer 3

Hepatitis C virus (HCV)

Question 4

True/False
There is vaccines available for HCV, but not for HAV and HBV

Answer 4

False
There are vaccines available for HAV, HBV, but no for HCV.

Question 5

What type of Hepatitis?
Infections occur only with HBV infection
-Dual infection of of this & HBV result in a more serious disease
and worse outcome.

Answer 5

Hepatitis D virus (HDV)

Question 6

True/False
Hepatitis B vaccines provide protection from HDV infection.

Answer 6

True

Question 7

What type of Hepatitis?
(a) Transmitted through consumption of contaminated water or
food.
(b) Common cause of hepatitis outbreaks in developing nations.
(c) Vaccines for this exist but are not widely available.

Answer 7

Hepatitis E virus (HEV)

Question 8

__________________ is typically an acute illness that many children in developing nations are infected by and remain asymptomatic. Chronic infection does not occur.

Answer 8

HAV

Question 9

True/False
HAV & HBV are both vaccine preventable and all AD military receive
the vaccinations

Answer 9

True

Question 10

______ and ______ can both remain dormant in the liver and cause chronic hepatitis & hepatocellular carcinoma

Answer 10

HBV and HCV

Question 11

What issue?
(1) Initially presents with non-specific flu like symptoms.
-(a) Fatigue, fever, muscle/joint pains, runny nose, pharyngitis, abdominal pain, nausea, vomiting, anorexia.
(2) Within 1-3 weeks, jaundice & RUQ pain develops
-(b) Secondary to the virus infecting & killing hepatocytes
-(c) Hepatocytes death releases liver enzymes in the blood
-(d) Hepatic dysfunction leads to increased bilirubin & jaundice.
(3) Physical findings:
-(a) Low-grade fever
-(b) Hepatomegaly with Liver tenderness
-(c) Jaundice & Scleral icterus
-(d) Right upper quadrant abdominal pain.
-(e) Dark or brown colored urine
-(f) Gray/clay colored stool

Answer 11

Hepatitis

Question 12

Causative virus cannot be differentiated based on clinical or
epidemiologic features.
-Since a large majority of hepatitis cases are viral, the IDC
should do what?

Answer 12

work to rule out other etiologies (medications, ETOH, toxins, etc.) first

Question 13

Hepatitis – Lab Diagnosis
_______serologic testing for presence of IgM and IgG and for specific components of viral hepatitis confirms diagnosis.

Answer 13

Hepatitis panel

Question 14

Hepatitis – Differential

Answer 14

other forms/etiologies of hepatitis

Question 15

Hepatitis – Treatment

Answer 15

IDC-level care consists of supportive/palliative interventions & patient
monitoring.
(a) Med Advice for further recommendations.
(b) Patient will require Medevac as soon as operational
conditions allow
(c) Ensure proper hydration & nutrition, and place patient SIQ.

Question 16

True/False
Hepatitis typically does not require emergent evacuation

Answer 16

True

Question 17

Hepatitis – Prevention
(1) Prevention of Hepatitis A and B involves completing the series of
vaccinations, which is a requirement for ______.
(2) Proper hygiene and __________.
(3) Appropriate use of _____ and following procedures to avoid needle sticks
(4) Use of _______ if participating in risky sexual activity.

Answer 17

1) ALL military personnel
2) handwashing
3) PPE
4) condoms

Question 18

Hepatitis – Disposition

Answer 18

Patients should be placed on a light-duty/bed-rest status based on the severity of the disease, and evacuated to definitive care as soon as possible for serious cases.

Question 19

What Tx is done at Major MTF for Hepatitis

Answer 19

Interferon