Viral hepatitis

Question 1

clinical signs of hepatitis

Answer 1

Typically malaise, myalgias, arthralgias, fatigue, anorexia, N/V/D

Question 2

this type of hep has no chronic form

Answer 2

hep A

Question 3

jaundice is seen in this age group MC with hep A

Answer 3

> 14 70-80% have jaundice

Question 4

how do you get hep A

Answer 4

fecal oral

Question 5

how do most hep A outbreaks occur in the US?

Answer 5

community wide outbreaks

Question 6

how to prevent hep A

Answer 6

• hand washing
• vaccine
• immune globulin if exposed
• IVF/supportive care

Question 7

IgM vs

IgG

Answer 7

acute phase

past exposure

Question 8

you are way more likely to get this disease than HIV from a needle stick

Answer 8

Hep B

Question 9

Risk of Chronic Infection After Acute Exposure is highest in

Answer 9

newborns of HepBeAg+ mothers

Actively replicating virus in the body (HBeAg), if mother has this then newborns are very likely to get chronic hep B

Question 10

this is used to monitor antiviral therapy for Hep B

Answer 10

HBV DNA

Question 11

this is the main test for Hep B and earliest indicator of acute Hep B infection

Answer 11

HBsAg

Question 12

Response to surface antigen, this means you cleared it or have immunity

Answer 12

HBsAb or anti-HBsAg

Question 13

Hep B virus is replicating and very infectious

Answer 13

HBeAg

Question 14

Hep D requires

Answer 14

Hep B, treat Hep B and D will go away

Negative RNA indicates recovery

Question 15

progression to chronic hep B is shown when

Answer 15

HBsAg is present forever

Question 16

extrahepatic manifestations of hep B

Answer 16

Polyarteritis Nodosa (bumps under skin)
glomerulonephritis

Question 17

how to tx Hep b

Answer 17

acute-no tx required

fulminant/chronic-antivirals

Question 18

as the pts ALT levels increase in response to chronic Hep B if HbEAg is +

Answer 18

more monitoring is required

Question 19

Lamivudine (Epivir)
Adefovir dipivoxil (Hepsera)

Answer 19

Nucleoside analog

less mutation shown

Question 20

interferon

Answer 20

bad side effects, pt feels crappy

Question 21

Entecavir (Baraclude)

Answer 21

guanosine analogue

very low mutation rate

Question 22

Tenofovir (Viread)

Answer 22

nucleotide analog approved for HIV and Hep B

Question 23

how do we define efficacy of tx

Answer 23

• termination of Hep B virus replication
• cessation of chronic liver injury
• disease free state

Question 24

Most common blood-borne infection in U.S.

Answer 24

Hep C

• Leading cause of cirrhosis/chronic hepatitis/Hepato- Cellular Carcinoma in U.S
• commonly asymptomatic

Question 25

acute vs chronic progression of ALT

Answer 25

acute shows increased ALT
chronic fluctuates ALT
anti HCV seen in both means you were exposed but still can have the disease

Question 26

extrahepatic manifestations of Hep B

Answer 26

• essential mixed cyroglobulinemia (Abnormal proteins which precipitate/dissolve depending on Tempº)
• small vessel vasculitis
• Porphyria cutanea tarda

Question 27

direct acting antivirals for Hep C

Answer 27

Ledipasvir-sofosbuvir (Harvoni)

Question 28

length of Hep C tx

Answer 28

12- 24 weeks (non-cirrhotics +/- RX-naïve)
Up to 48 weeks (cirrhotics +/- RX failure)
HCV/HIV coinfection: typically longer course of DAA