Viral Hepatitis Flashcards

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1
Q

List the viral causes of the viral hepatitis;

A

HAV- picorna
HBV -Hepdna
HCV- flaviviridae
HDV -Delta
HEV - Calici/herpe
HGV- flavi

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2
Q

List the other viral cause of hepatitis

Tips:4zoonotic virus: 2Neonates, 2 fevers, Nigeria had it in your jss3

A

Marburg,
Ebola
Lassa fever
CMV in neonates
Herpes simplex in neonates
Yellow fever.

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3
Q

Another name for HBV

A

Serum hepatitis B virus

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4
Q

When was HBV discoverd

A

1942, amongst soldiers

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5
Q

Who and when was Au antigen found in serum discovered

A

1965 by Blumberg

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6
Q

Who used electron microscopy to describe hepatitis B in serum

A

1970 by D.s Dane

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7
Q

Which is a small hepatotrophic DNA virus that infects only humans

A

Hepatitis B virus

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8
Q

What is the major cause of Chronic liver, hepatocellular carcinoma and polyarteritis nodosa.

A

Hepatitis B virus

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9
Q

Infection of HB can be Acute or chronic T/F

A

True

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10
Q

List the extraheptic manifestation of HBV

A

Polyarteritis Nodosa,
Arthritis
Pericarditis
Glomerulonephritis
Transient serum sickness

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11
Q

◀️◀️◀️◀️◀️INTRODUCTION

A
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12
Q

EPIDEMIOLOGY▶️▶️🔜

A
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13
Q

Tips:
List it’s position in the world’s death
Mention the number of people that have it per year.
Mention it’s Antigenic cause
Mention the metrics (million)in a chronic conditions.
List the percentage distribution in a locality

A
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14
Q

What’s the position of HBV in the world death

A

9th

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15
Q

How many people have HBV in a year

A

About a million

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16
Q

How many people present with HBV chronically globally

A

350million

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17
Q

What’s the causative antigen

A

Hepatitis B surface antigen (HBSag)

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18
Q

What’s the distribution in Sub- Saharan Africa and East Asia

A

More than10% of population has it.

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19
Q

CLASSIFICATION 🔜🔜

A
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20
Q

How many subgenotype does HBV have ?

A

8

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21
Q

Which geographic location has Subtype A

Tip cAbin

A

Cameroon
Burundi
India
Norway

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22
Q

Which geographic location has Subtype B

CV…..

A

China
Vietnam
East Asia - Korea
Societal island

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23
Q

Which geographic location has Subtype C

Top: BC

A

China and Bangladesh

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24
Q

Which geographic location has Subtype D

Tips: Dinats

A

Denmark
India
North Africa
Tunisia
Sweden

25
Q

Which geographic location has Subtype E

Tips: SwedeN

A

Sweden,
Nigeria

26
Q

Which geographic location has Subtype F.

Tip: I failed CVS painfully then I columbi it

A

C- columbia
V- Venezuela
S- spain

27
Q

Which geographic location has Subtype G

A

United States

28
Q

Addendum to EPIDEMIOLOGY

A
29
Q

What percentage of acute HBV in adults grows into chronic conditions

A

5%

30
Q

What percentage of acute HSV in children grow into Chronic condition

A

93%

31
Q

What are the advantage of those previously infected with HBV and cleared it completely?

A

It confers some kind of immunity against reoccurrence

32
Q

What is the reason why the carrier rate of HBsAg in this part of the world is in the increase?

A

This is because of it’s Perinatal transmission

33
Q

RISK FACTORs🔜🔜

A
34
Q

List the risk factors of HSV

A

Blood transfusion
Through needles/syringes
Tattooing
Perinatal
Multiple sexual partners

35
Q

MODE OF TRANSMISSION

A
36
Q

List the mode of transmission of HBV

A

▶️ Sexual transmission; having multiple sexual partners

Risk is 30%

◀️ Parenteral transmission; through IV; seen in patients having Hemophilia, renal dialysis,organ transplant.

Risk is 5%

▶️ unknown mode of transmission; 27%

37
Q

Why does perinatal hepatitis happen

A

This is due to the absence of exposure prophylaxis to mother’s before delivery, so they transmit to child

38
Q

Rate the percentage of infectiveness and chronicity ,when mother has positive HBsAg and HBeAg

A

70-90% are infected
90% becomes chronic carries…

This is because of the replicating and infective power of HBeAg

39
Q

What is the percentage of infectiveness and chronicity when mother has positive HBsAg

A

<10% of infant is infected

But 90% of infected infants are chronic carriers

40
Q

REPLICATION

A
41
Q

CLINICAL FEATURES 🔜🔜

A
42
Q

What is the incubation period of HBV

A

120days on an average

45-160days

43
Q

Which age group in children are likely to have jaundice and in what percentage

A

> 5yrs

Percentage: 30-50%

44
Q

Which age group in children are not likely to have jaundice and in what percentage

A

<5yrs
Percentage= <10%

45
Q

At what percentage does acute phase lead to death

A

0.5-1%

46
Q

Using the age 5 yrs as a middle man which age is likely to have chronic infection and their percentage?

A

<5yrs

25-90%

47
Q

Using the age 5 yrs as a middle man which age is not likely to have chronic infection and their percentage?

A

> 5yrs

6-10%

48
Q

What percentage of premature mortality can be gotten from chronic liver disease

A

15-25%

49
Q

List the clinical presentation of HBV

A

Prodrome: fever, malaise, nausea, vomiting, diarrhea.

Jaundice may occur but Anicteric hepatitis is more common i.e hepatitis without jaundice.

Chronic infection complications; Liver cirrhosis, hepatocellular carcinoma

50
Q

What are the features of Acute phase HBV

A

It is a new infection

Symptoms are more common in adults

Children are symptomatic

Infection resolves in someone in immunity

Infection can persist and continues into chronic phase

51
Q

What are the features of Chronic HBV infection

A

Individual carry it for more than 6months

Virus doesn’t develop anti- HBsAg

It’s a silent infection

Affects children more commonly

52
Q

What is the most common symptom of active carrier state in pts with HBV

A

Fatigue

53
Q

In inactive carrier state what amount of DNA copies are seen per mililiter

A

0-30,000copies

54
Q

GOALS OF ANTIVIRAL TREATMENT OF CHRONIC HBV

A
55
Q

List the targets of sustained suppression of HBV replication

A

To reduce the HBV DNA serum level to.
<10^5

To clear HBeAg to Anti-HBE seroconversion

To clear HBSAg to Anti-HBs seroconversion

56
Q

List the targets of Remission of liver disease

A

To reduce serum ALT levels

To reduce serum Alkaline phosphatase levels

To decrease necroinflammation of the liver

57
Q

List the goals target to improve clinical outcomes

A

To reduce cirrhosis development
To reduce liver failure
To reduce hepatocellular carcinoma
To increase survival

58
Q

TREATMENT

A
59
Q

List the approved drugs for HBV treatment

A

Interferon alpha2b
Peginterforn alpha 2a
Telbivudine
Lamivudine
Entecavir
Adefovir
Tenofovir DF
Emtricitabine/ tenofovir combination.