Brainscape's Knowledge GenomeTM

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


See full index

Labs Medicine > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

Besdies the hepatitis viruses, what other viruses can cause hepatitis?

A

CMV
EBB
HSV
Parvovirus B19

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

Describe the presentation of Hep A?

A

aself limited illness with jaundice, fatigue, fever, anorexia, diarrhea, dark urine, pale stools, abdominal pain

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

How is the spread of Hep A?

A

fecal-oral

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

How long is the incubation for Hep A?

A

15-50 days

2-6 wks

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

Why has Hep A incidence declined since the 1990s?

A

a vaccine became available

only 1200 cases in the US in 2014

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

What are the appropriate serologic tests for HAV?

A

Total Anti-HAV antibody (indicates acute, previous infections or immunization)

IgM Anti-HAV (indicates acute infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Who shoul dbe vaccinated for hep A?

A

all kids at 1 yo
kids 2-18 yo where routien vacc is implemented
travelers to high prevalence areas
Men who sleep with men
high risk: drug users, occupational exposures
chronic liver disease patients
patients receiving clotting factors

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

What percentage of the 3-4 million people in the US with hep C are diagnosis?

A

only 25-50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the rate of chronic hep C infection?

A

75-85%

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

What is the rate of chronic liver DISEASE?

A

60-70%

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

What is the rate of cirrhosis in the next 20-30 yrs?

A

5-20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When can you start to detect viral hep C RNA in the blood?

A

1-3 weeks post exposure

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

When can you start to detect hep C antibodies?

A

can take 20-150 days before you can see the antibodies

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

Who’s more likely to clear the hep C virus - people who get acutely sick or people who are asymptomatic?

A

symptomatic patients more likely to seroconvert

so you want to get sick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the HCV modes of transmission?

A

percutaneous exposure to infected blood

sexual transmission (less common)

mother to child (4% risk of trans in preg/labor)

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

What are the lab test options for HCV?

A
  1. screening with EIA/CIA
  2. Molecular assays (quantitative and genotyping)
  3. liver biopsy not usually needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Positive antibody screens for HCV should be confirmed by what? Unless?

A

usually RNA detection

unless their titer is super high, then you can just go on th eone test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the ost common genotypes of HCV in the US?

A

1a and 1b

2 and 3 less common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some reasons for false negative results?

A

immunosuppression
low levels of anti-HCV Ab
Absence of antibodies against antigens in the test (if they’re directed at a different part of the virus than the test is looking for)
testing in the “window period” - before 11 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Is it possible using the antibody screening test for HCV to determine acute, chronic or resolved infection?

A

no

that’s why you look for the RNA confirmation - is there actually virus in the patient’s blood?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Who should be screened for He pC?

A
  • people born between 1945-1965 (baby boomers)
  • hx of IVDU
  • Recipients of clotting factor concentrates made before 1987
  • recipients of blood transfusions/solid organ transplants before 1992
  • Patient who have ever received long-term hemodialysis treatment
  • known exposure
  • w/ HIV
  • kids with HCV moms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the goal for treatment HCV?

A

sustained virologic response (indetectable viral RNA 24 wks after therapy completed) - basically cure now

23
Q

Is hep B a DNA or RNA virus?

A

DNA

24
Q

How does age of infection with HBV affect severity and chronicity?

A

younger, more likely to go on to chronic

older - more likely to be acutely sicker

25
Q

Who should be vaccinated for HBV?

A

everyone udner 18

everyone over 18 with increased risk

26
Q

What kind of vaccine is used for HBV now?

A

recombinant form of hBsAg

27
Q

WHat’s the transmission for Hep B?

A

contact with infected blood or mucosal membranes (sex, IVDU,sick mom, needle sticks, etc)

28
Q

What is the incubation for hep B?

A

60-150 days

2-6 mp

29
Q

What is the first serologic marker for HBV to appear?

A

HBsAg

surface antigen

30
Q

WHen does surface antigen disappear?

A

1-3 months after the ajundice (when you get anti-HBs)

if it doesn’t clear = chronic infection

31
Q

Does the Anti-HBs go away eventually?

A

nope - persists indefinitely

also will be positive in immunized persons

32
Q

WHen is Anti-HBc (core antibody) positive?

A

during the window when surface antigen is declining and surface antibody is appearing

can persist for years

33
Q

WHen does envelop antigen appear?

A

with surface antigen

34
Q

What does envelope antigen indicate?

A

presence of intact virions, = means it’s actively replicating and dividing

35
Q

surface antigen negative
anti core negative
anti surface negative

A

never been exposed, non-vaccinated

36
Q

sufact antigen negative
anti-core neg or positive
anti-surface positive?

A

seroconversion

so either resolved (positive anti core) infection or vaccinated (negative anti-core)

37
Q

surface antigen neg
anti-core positive
anti-surface negative

A

window period! patient IS infected, but it looks favorable because they’re clearing surface antigen

38
Q

Surface antigen positive
anti-core igM positive
anti-surface negative

A

acute hepatitis infection

39
Q

surface antigen positive
anti-core IgM neg, IgG positive
Anti-surface negative

A

chronic infection (IgG anti-core and no anti-surface)

40
Q

How is hepatitis D transmitted?

A

percutaneous exposure

41
Q

What kind of virus is hep D?

A

defective RA virus

42
Q

Hep D needs to be a coinfection with what?

A

hep B

43
Q

What is the difference between co-infection and superinfection

A

co-infection isyou get with B and D at the same time

superinfection is when chronic HBV carriers get D later

44
Q

Which one has worse acute disease - co-infection or superinfection?

A

co-infection, but less will go on to develop chronic infection

45
Q

How can you test for HDV?

A

you dan do an assay for total anti-delta or just IgM for acute infection

also can do a molecular analysis to detect RNA

46
Q

Where is Hep E located globally

A

asia
india
middle east
mexico

47
Q

WHat is the indubation period for hep e?

A

2-8 wks (similar to A)

48
Q

Who have a high mortality with hep e?

A

pregnant women (up to a third will die!)

otherwise it’s usually a self-limited disease

49
Q

What is hep G?

A

an RNA virus transmitted by blood, maybe causes mild disease. not a significant health problem

50
Q

Bsaic workup for acute viral hepatitis will include what?

A 
IgM anti-HAV
IBsAg
IgM Anti-HBc
anti-HCV
anti-HDV (if fulminant disease, or known HBV)
51
Q

Can a negative anti-HCV exclude acute infection?

A

nope - there’s a window period

52
Q

What is the basic panel for chronic hepatitis testing?

A

HBsAg (if positive, do HbeAg and anti-HDV)

Anti-HCV (if positive, do RNA PCR)

53
Q

What are some nonviral etiologies of chronic hepatitis?

A 
chemical injury, drugs, alcohol
autoimmune hepatitis
hemochromatosis
alpha1 anti trypsin def
wilson's

Labs Medicine (27 decks)

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