Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm 446 Midterm #1 > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

What are the 2 RNA hep viruses?

  • which one is DNA?
  • which hep doesnt cause chronic hep?
  • chronic hep rates with hep B vs C?
A

RNA= hep A and C {think: RAC}

DNA: hep B

  • A
  • B: 10%, C: 70%.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hep A:

  • what kind of virus is hep A?
A

NON-ENVELOPED RNA virus (VERY stable, can hide in for long time outside body, in water, sewers etc).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hep A transmission?

A

fecal oral –> concerned with carriers handlign FOOD. poop to mouth.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

in Hep A, what is responsible for DAMAGING THE LIVER CELLS?

  • ONCE infection is cleared, is hepatic damage repaired?
  • why are children often ASYMPTOMATIC COMPARED TO AUDLTS?
A

it’s the IMMUNE SYST RESPONSE TO VIRUS, not the virus itself!

yes!

  • Cuz their immune system is more immature.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why can you give hep A right before going on a trip? and can still give post exposure hep A vax?

When does ALT peak in Hep A ?

A

cuz of long incubation period (28 d).

When clincial illness starts to go up around 3-4 wks after exposure!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are ways of PREVENTIONG Hep A? 4

A
  • proper handwashing and sanditation
  • boil water/food (bottled water)
  • hep A vax
  • Immunoglobulin if can’t be vaccinated or if need immediate protection cuz was exposed long time ago.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is HepA trx?

A

generally self limiting, so just supportive and sx care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hep B:
What type of virus is Hep B?

A
  • ENVELOped DS DNA
    {enveloped= means less stable virus ; think: it’s inverse}
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

in Hep B, why are older adutls more able to clear Hep B virus compared to children and immunocompromised?

A

cuz of theiri stronger immune system, so they’re less liekly to become chronically infected. That’s why we’re more worried about Hep B infection in those with WEAKer immune systems (young, elderly, iC’d).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hep B Signs & Sx:
- Can both acute and chronic Hep B be asymptomatic?

  • what are the msot common sx of acute hep B?
  • What labs would distinguish btwn ACUTE AND CHRONIC HEP B?
A

yes!

  • hep B sx: fever, fatigue, loss of appetitei, n/v, possibly jaundice (basically, just feeling liek you have a virus).

Labs:
- chronic hep if HBsAg positive for more than 6 months
- and intermittent elevations in ALT/AST.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the GOALS of therapy for Hep B?

  • what is the best course for hep B?
  • is there a cure for HepB?
A
  • best course is Prevention! so Hep B vaccination.
  • since no CURE for hep B, goal is to SUPRRESS HBV-DNA REPLICATION to PREVENT DISEASE PROGRESSION and mortality.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some ways to PREVENT Hep B? 4

A

Hep B vacc

Hep B immunogloublins for passive immunity.

barrier protection cuz this is sexually transmitted and blood borne.

Avoid sharing tools that could be contaminated with blood (needles, razors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When did blood banks start screening for Hep C?

A

1990

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Whcih Hep is the numer 1 cause of liver cirrhosis, liver related deaths, and liver transplants?

A

Hep C

  • rates higher in areas with lower medical standards (sharing needles etc- africa nad egypt).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

_____ of pppl living with hep C are unaware.

A

20-44%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the pops DISPROPROTIONATELY affected by HCV?

  • those born btwn 19__ -___
A

Indigenous people, people who inject drugs, immigrants, homeless or
incarcerated populations, as well as those born between 1946-1965

  • basically, anyone in lower socioeconomic statuses cuz less access to care.
17
Q

Which provinces have hvae the highest rates of HCV and why?

A

SK and MB- more drug use

18
Q

How is Hep C transmitted?

it’s a ____ Illness
–> is it highly contagious through sexual contact?

  • primarily through sharing ______
  • unsterile _______/____.
  • unsterile _______/____.
  • can it be transmitted from parent to child ? risk ?
  • reusing what?
A
  • blood borne!!! It “Can” be transmitted sexually, but not efficient transmission sexually and it’s probs from trace amounts of blood more likely.
  • primarily through sharing needles
  • unsterile tattooing/body piercing.
  • unsterile medical/dental procedures
  • can be transmitted from parent to child (5% risk, but not reason to not have kids).
  • reusing tools that could be contaminated with BLOOD (razors, tooth brush, nail clippers).
19
Q

Which Hepatitis is MOST infectious in terms of blood-borne transmission?

A

Hep B > C > HIV

20
Q

Hep C:

  • what type of virus is Hep C?
  • how many genotypes of Hep C exist?
  • Are new treatments effective against all genotypes of HepC?
  • How does the Hep C virus actually DAMAGE the hepatocytes?
  • why is it so challenging to find a vax to hep C?
A
  • single stranded rna
  • 6
  • yes!
  • Virus itself can lead to damage to hepatocytes, continusou cell-cell spread and therefore chronic inflammation.
  • frequent mutations
21
Q

Hep C presentation:
- usually _________
- When is HCV detectable from exposure?
- general sx?

A
  • asympt
  • within 1-2 wks and ALT spikes during acute infection
  • general: like other hep infectiosn –> fatigue, weakenss, anorexia, abd pain, jaundice.
22
Q

Hep C clinical course if untreated:
- Waht percentage of acute HCV infection proceedds to resolution vs CHRONIC HCV?

  • What percentage of chronic HCV develops into cirrhosis?
  • of the cirrhosis, waht percentage leads to lvier cancer?
  • when do ppl start developing cirrhosis from exposure?
A
  • 75% will dvlp chronic hep C
  • 25 % will clear on own w/o further issues.
  • 20%
  • 1-4%
  • 20 yrs after exposure.
22
Q

Hep C clinical course if untreated:
- Waht percentage of acute HCV infection proceedds to resolution vs CHRONIC HCV?

  • What percentage of chronic HCV develops into cirrhosis?
  • of the cirrhosis, waht percentage leads to lvier cancer?
  • when do ppl start developing cirrhosis from exposure?
A
  • 75% will dvlp chronic hep C
  • 25 % will clear on own w/o further issues.
  • 20%
  • 1-4%
  • 20 yrs after exposure.
23
Q

What are some ways to PREVENT HEP C TRANSMISSION?

  • avoid sharing what?
  • cover _______
  • education on risk of what?
  • clena blood spills with what?
A
  • avoid sharing razors, tooth brushes etc
  • avoid sharing needles
  • cover bleeding wounds
  • education on risk of sexual transmmission ( usualyl from bleeding- so like, anal sex).
  • clena blood spills wiht bleach
24
Q

Why is it imp to screen hep C?

  • why imp to treat?
A

cuz there’s a CURE FOR HEP C.

  • cuz trx is prevention (prevents transmission), assoc sig morbtity , mrotialtiy and cost.
25
Q

Who should primary care providers test for HCV?

Current or history of _____ use
* Born or had medical/dental treatment in HCV _____ countries
* Received healthcare where there is lack of _____.
* Children > 18 months of age born to mothers with ____
* Received blood transfusions, blood products or organ transplant in Canada
before 19___
* History of ___
* History of _____ injury
* Patients with _______ ALT
* Other risk factors: high-risk sexual behaviours, homelessness, intranasal drug use,
tattooing, body piercing, or sharing personal care items with someone who is HCVinfected

A

Current or history of injection drug use
* Born or had medical/dental treatment in HCV endemic countries
* Received healthcare where there is lack of universal precautions
* Children > 18 months of age born to mothers with HCV
* Received blood transfusions, blood products or organ transplant in Canada
before 1992
* History of incarceration
* History of needle-stick injury
* Patients with persistently elevated ALT
* Other risk factors: high-risk sexual behaviours, homelessness, intranasal drug use,
tattooing, body piercing, or sharing personal care items with someone who is HCVinfected

26
Q

When shoudl testing and blood work be done for Hep C?

A

at least 3 months after exposure.

27
Q

What are the 2 steps in Hep C testing and blood work?

1) Initially scren for HCV abys.
- if Aby- positive –> what indicates?

2) If test positive for HCV abys, THEN what lab test is done?

  • if Aby +, RNA + : what means?
  • IF Aby + and RNA - : what means?
A

1) Initially scren for HCV abys.
- if Aby- positive –> indicates acute, chronic or past infection, but doenst distinguish btwn the 3.

2) If test positive for HCV abys, THEN do a QUALITATIVE HCV RNA ASSSAY (pcr).
- if Aby +, RNA + : lab AUTOMATICALLY complete reflex testing to CONFIRM IF HCV RNA is present . if + –> means have CURRENT HEP C INFECTION.

  • IF Aby + and RNA - : means HCV infection has cleared.
28
Q

What is hte name of the point of care rapid testing for HCV that uses a fingerstick poke (looks like covid antigen rapid tests)?

A

OraQuick –> Fingerstick

29
Q

What are the advantages of ora quick?

Disadvantages?

Adv:
- conveneience?
- ____ sens and speicifci
- rsults available how quickly?
- ___ barrier for testing
- easy to adapt to diff settings

disadv:
- still needs waht?
- results dont show up where?
- pts often need to be _____ fro aother things/

  • does gov cover?
A

Adv:
- easy- no need for lab
- sens and speicifci
- rsults available in 20 mins
- low barier for testing
- easy to adapt to diff settings

disadv:
- still needs confiramtory testing of HCV rna (qualiatiive HCV rna assay on pcr)
- results dont show up on netcare
- pts often need to be screened fro aother things/

  • Gov dosent cover, so pt or pharm has to pay.
30
Q

What is the other point of care testing for HCV?

A

dried blood spot testing.

31
Q

Adv of Dried blood spot testing?

  • waht is the one biggest adv?
  • what are the 2 biggest disadvantages?
A

Adv:
- easy
- good sens and sp
- *** CAN DETECT HCV RNA AND viral load so is Almost confirmatory for hep c.
- can also screen for multiple infections.
- easy to adpat to didf f settings
- low barrier testing.

Disadvantages:
* BUT NOT YET WIDELY AVAILABLE
* AND RESULTS NOT IMMEDIATE. Takes 2-3 wks for results from lab.

32
Q

What are some imp counsellign pts for adults with HCV to reduce liver damage?

  • Reduce ____consumption
  • _____ cessation (liver cancer)
  • _____ vax
  • maintain healthy _____
  • limiti _____ drugs
A
  • Reduce alcohol consumption
  • smoking cessation (liver cancer)
  • hep a and b vax
  • maintain healthy weight & healthy diet (obesity adds risk to liver health)
  • limiti hepatotoxic drugs
33
Q

Waht is some additional blood work to order in pts with HCV infection?

  • which aby tests? 5
  • which std lab tests? (3)
A
  • Anti-hep A IG aby, Hep B surface antigen, Anti-Hbc, Hbs aby and HIV aby.
  • AST/ALT, CBC (platelets) and creatinine.
34
Q

What calculated score is used to determine whehter a pt has fibrossi?

– If FIB-4 > _____ – refer to specialist
– If FIB-4 < 3.25 – ________

A

FIB-4 score.

– If FIB-4 > 3.25 – refer to specialist

– If FIB-4 < 3.25 – seek advice (phone or written)
from specialist

35
Q

Who shoudl be treated with HCV trx?

Who is eligible for “simplified trx”?

A

EVERYBODY WHO HAS A CHRONIC HCV INFECTION. –> Exception in those with those who arent gonna live that long anyway (ie/ have cancer).

  • adults with HCV who DO NOT HAVE CIRRHOSIS and have not previously received hep C trx.
36
Q

What ar the goals of therapy for HepC?

  • how is cure for hep C measured?
A

CURE!!

  • Measured by absence of detectabel HCV RNA at least 12 wks after COMPLETING therapy.

–> Other point: ppl will still have HCV ANTIBODIES after cure, BUT HCV RNA will not longer be present. (Abys remain for lifetime)

37
Q

why do we measure cure for hcv at min 12 wks after END OF TRX?

A

BEFORE THAT, MAY GIVE you false positives so cant be confident in results.

38
Q

Hep C DIRECT ORAL ACTING AGENTS

  • all end in waht suffixes?
  • what are the suffixes for the following:

NS3/4A protease inhibitor?
NS5B polymerase inhibitors?
Ns5A inhibitors?

A
  • previr, buvir, asvir. .

NS3/4A protease inhibitor? previr
NS5B polymerase inhibitors? buvir
Ns5A inhibitors? asvir

Pharm 446 Midterm #1 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions