Viral Hepatitis Flashcards
Aetiology (causes) of viral hepatitis
•________
•__________ infections
•_________ disorders
•________ - alcohol, drugs, aerosol sprays, paint thinner.
•___________
Viruses
Bacterial
Metabolic
Toxic
Immunologic
Metabolic diseases
• They cause (acute or chronic?) hepatitis commonly and these are:
• In-born error of metabolism such as -____________ deficiency
-Abnormality of______________
-____________
-__________ disease
Chronic
Alpha 1 antitrypsin
carbohydrate metabolism
Hemochromatosis
Wilson’s
Alcohol induced liver disease
• This cause a variety of lesion in the liver as a result of its direct toxic effect.
• Alcoholic _______ (_________)
• Alcoholic ___________
• Liver ________
steatosis; fatty change
hepatitis
Cirrhosis
viruses
• Hepatotropic virus such as ______________- classically cause “viral hepatitis’
•_____-newborn or immunosupressed.
•__________ virus.
• ______ – mild hepatitis.
• ________ virus
• ________viruses.
hepatitis A-G
CMV
Yellow fever
EBV
Rubella
Adeno
From hepatitis A- G,
Which is DNA, which is RNA
DNA- B
RNA- A,C,D,E,F,G
From hepatitis A- G,
Which ones are chronic and which ones aren’t
Chronic - B,C,D
Acute- A,E,F,G
From hepatitis A- G,
List the mechanism of spread
A-faeco-oral
B-parenteral, perinatal, sexual
C-parenteral, sexual, sporadic
D-superinfection, coinfection with HBV
E-faeco-oral, epidemic, sporadic
F-parenteral, sporadic
G-parenteral, sporadic, vertical
Hepatic manifestation
Herpes simplex
Herpes zoster
Adenoviruses group
Necrotizing hepatitis
Hepatic manifestation
Cytomegalovirus
Rubella
Hepatitis, neonatal giant cell hepatitis
Neonatal hepatitis
Hepatic manifestation
Epstein-Barr
Enterovirus (B coxsachie)
Measles (rubeola)
Parvovirus
Hepatitis, granulomas, lymphoproliferative disorders
Hepatitis, haemorrhagic necrosis
hepatitis
Hepatocyte ballooning
Viral hepatitis
• This is the inflammation of the liver caused by _______ viruses
hepatotropic
hepatotropic viruses, so called because ____________________
they have high affinity for the liver.
hepatotropic viruses
• These are hepatitis ________________ viruses
More are still being discovered
A,B,C,D,E & G
Hepatitis A virus
• Discovered 1973
•____nm
•___RNA
•______virus
27
ss
picorna
Hepatitis A virus
• Infection is common in ______________- income countries with (good or poor?) sanitary conditions and hygienic practices.
It is (low or high?) in high-income countries.
low- and middle
Poor
Low
Hepatitis A virus
• Incubation period is ________
• It lives in _______ in the ______
14-28days
faeces
intestinal tract
Hepatitis A virus
• Transmitted by _____ route-
faeco-oral
HAV
• Contaminated _____ to wash _______
• Contaminated _______/_______
• Eating __________________ harvested from infected water
water; fruits and vegetables or
ice block/pure water
raw/partially cooked shellfish
HAV
• Infectivity starts ______ before symptoms (jaundice) appears and continue _____ after
• May also cause ________.
•
2wks; 1wk
diarrhoea
Acute HAV is more severe in (adult or children?) than in (Adult or children?)
Adult
Children
HAV infection is clinically distinguishable from other types of acute viral hepatitis.
T/F
F
HAV infection is not clinically distinguishable from other types of acute viral hepatitis.
HAV infection
• Specific diagnosis – detection of HAV-specific ___________(_____) antibodies in blood.
• Additional test –______ to detect _____
immunoglobulin G (IgM)
RT-PCR
HAV RNA
HAV infection
• Less than 1% of cases will develop ____________
fulminant hepatic failure.
Treatment of HAV infection??
No treatment, most will recover
HAV infection
Chronicity (yes or no?)
cirrhosis (yes or no?)
cancer-(yes or no?)
No
No
No
Hepatitis B virus
• ____nm
•___DNA
•_______virus
• Incubation Period: _________
45
ds
hepadna
30-180days;
Hepatitis B virus
• Found in ____________________
•_______% of neonatal HBV progresses to chronic hepatitis
blood and other body fluids
90-95
Hepatitis B virus
• Chronicity (yes or no?)
cirrhosis (yes or no?)
cancer (yes or no?)
Yes
Yes
Yes
_______% of neonatal HBV progresses to chronic hepatitis
____% of adult HBV becomes chronic hepatitis.
90-95
5
About _____% person living with HBV infection (2.7million) are also infected with HIV infection.
1
HBV Carrier state
–very (common or rare?)
______% of acute Hepatitis
Common
5-10
HBV Remains in the body even after transplantation
T/F
T
Transmission of Hepatitis B virus
• Transfusion of _________
• Unprotected ____________,_______
• Sharing _________ among ______
• Use of _______ by __________ to ______
• contact with semen, sweat, tears, saliva,breast milk, effusion
•__________ to ________ during _______
blood and blood products.
sexual intercourse,
• Anal sex
infected needles among drug abusers
infected needles by quacks, chemists to give injection
Mother to child (90-95%) during childbirth
Risk factors for HBV
•_______ in patients with kidney failure
• ______________ among health workers
•_________ activity
•__________,_________
Dialysis
Needle stick accidents
Homosexual
Circumcision, tattooing.
• H____V; most versatile.
B
Course of HBV infection
• Can cause _______,______,_______, and ___________
• Present in _____ body fluids except _____ and produces several antigens:
acute, chronic, acute severe fulminant hepatitis and liver cirrhosis,
all; stool
Course of HBV infection
– HBsAg appears before _____, peaks during _______ and declines in ________
– HBeAg, HBVDNA & DNA polymerase – are markers of ______, which leads to _____
– HBcAg
onset; overt disease ; 3-6month
active replication/ active infection
chronic
Course of HBV infection
– HB___Ag appears before onset, peaks during overt disease and declines in 3-6month
– HB___Ag, HBVDNA & DNA polymerase – are markers of active replication/ active infectionchronic
– HB__Ag
s
e
c
HBV
• The body produces antibodies to these antigens - anti HB___, Anti HB__ & anti HB__.
c, e,s
HBV
Anti-HBe detectable after ____________
• Anti -HBc IgM appears before ___________ and later replaced by _____
• Anti-HBs appears after __________ and remains ______
disappearance of HBeAg
onset of disease ; IgG
acute disease is over
for life
Anti-HBs is detectable at the window periods
T/F
F
Anti-HBs is not detectable at the window periods
Prevention of HBV
WHO recommendation:
•take _________ as soon as possible after birth
HBV vaccine