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Path - Microbiology > Viral hepatitis > Flashcards

Viral hepatitis Flashcards

1
Q

which of the hepatitis viruses are rna and which are DNA?

A

All are RNA apart from hep B

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2
Q

hep a virus is of which family?

A

Picornaviridae

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3
Q

which hep viruses are of feace-oral contact?

A

Hep A and E

the first and the last

an image of a table is very helpful

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4
Q

patient comes back from India, 6 weeks later they develop, jaundice, RUQ discomfort.

diagnosis?

A

hep a

come from an endemic area
Incubation period: 2-6 weeks

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5
Q

which hepatitis produce chronic infection and which don’t?

A

Chronic: B, C, E

No chronicity: Hep A

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6
Q

Which liver marker do we look at with hepatitis serology?

how does it change?

A

ALT - usually raised

2-3x normal - not in thousands!

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7
Q

patient has Anti-HAV IgM in serology. meaning?

A

acute infection

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8
Q

patient has Anti-HAV IgG in serology. meaning?

A

past infection OR vaccination

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9
Q

what advice would you give to hep A patient regards to work?

A

Advice for patient: stay off work for 7 days from onset symptoms

BECAUSE are infectious 2 wks before symptoms start

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10
Q

when are people given a hep A vaccine?:

A

for pre-exposure prophylaxis or recent exposure:

Travel to high risk country
Chronic liver disease
Haemophilia
People who inject drugs ‘PWID’
MSM - men who have sex with men
Occupational risk: lab, residential facilities, sewage work
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11
Q

treatment for some1 with confirmed hep A?

A

no cure

supportive care

liver transplant if deteriorate

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12
Q

in those with hep a, which group are most likely to present with jaundice

A

adults / over 14s

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13
Q

which virus is of the hepadnavirus family?

A

Hep B

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14
Q

which hep viruses are transmitted via:

sexual, parenteral, vertical

A

Hep B

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15
Q

characterise chronic infection in

  1. Hep B
  2. Hep E
A

B: HBsAg positive > 6 months

E: HEV RNA positive > 3 months

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16
Q

which hep virus has the longest incubation period?

A

Hep B - 2-6 months

hep c can also be 6 months but can start in weeks too

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17
Q

how many under 5s develop hep B?

A

90%

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18
Q

how many adults develop hep b?

A

10%

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19
Q

kids with acute hepatitis infection present how?

A

no symptoms

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20
Q

what part of the hep b drug structure is a target?

A

dna polymerase

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21
Q

what is the order of hep b structural components from outside to in?

A

surface antigen
e antigen
core antigen
ds DNA and dna polymerase

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22
Q

HBsAb: marker of _____ ?

A

IMMUNITY

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23
Q

core+envelope Ab positive denotes?

A

past infection

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24
Q

core+envelope Ab negative, SAb + denotes?

A

vaccination

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25
SAg- EAg - Core Ab- Sab + denotes?
vaccination
26
mnemonic of decreasing order of abundance igs?
GAMED g most abundant because for long term immunity
27
Anti-HBc IgM (core IgM) means?
acute infection
28
what components of the hep b can't you have in vaccine?
e and core antigen
29
which is the marker of active replication i.e. infectiousness
e antigen HBeAg
30
Anti-HBe means?
past/chronic
31
HBV DNA means?
active replication
32
SAg+ EAg+ Core Ab + denotes?
Acute infection - if IgM Chronic infection - if IgG. high risk
33
SAg+ EAg- Core Ab +
Resolving acute chronic low risk
34
SAg- EAg- | Core Ab +
resolved infection reactivation risk - latency NOT a vaccine because its CORE antibody not surface
35
SAg- EAg- Core Ab - SAb -
no exposure - not immune vaccinate risk groups
36
how long after infection are Anti-HBs (HBsAb positive) | made? in acute infection
8 months / 32 weeks
37
what does serology look like in acute hep b with recovery?
RECOVERY: HBsAg loss Anti-HBs (HBsAb positive)
38
what does serology look ini in chronic hep b?
NO surface antibody BUT you get core antibody: Igm + igg LOTS of HBsAg
39
what's the gold standard card in cirrhosis diagnostics?
histopath
40
ivx for hcc : hepatocellular carcinoma?
AFP - also high in pregnancy imaging : ULTRASOUND
41
patient with test signs: Radiology: coarse echotexture, nodularity, portal HTN – splenomegaly which condition?
cirrhosis
42
who with Hep B should be treated?
HBeAg + HBV DNA > 20k & ALT x2 Cirrhosis + HBV DNA detectable - the greater the load of hbv dna, the gr8er risk of cirrhosis and HCC
43
what do you want from hbv treatment?
REDUCE HBV DNA load!! also SAg , eAg too. ALT normalization
44
mmemonic for HEP B treatment?
TILE T- Tenofovir* I - pegylated interferon alpha L- lamivudine E- Entacavir* *NRTI
45
what is the MOA of NRTIs?
inhibit DNA polymerase high genetic barrier to resistance - tenfovir and entecavir
46
which hep b drugs indue eAg, sAg loss
pegylated interferon alpha sc injections bad side effects
47
how long to take tenfovir and entecavir for?
until HBsAg loss
48
how is hep b prevented in UK?
Routine Vaccination: | 2 months, 3 months, 4 months
49
is baby is HBsAg positive, eAg negative how to treat?
vaccine at birth + routine schedule
50
HBsAg positive, eAg positive how to treat?
vaccine at birth PLUS HBIG within 48 hours
51
what does the hep b vaccine consist of?
Recombinant vaccine (HBsAg)
52
can you get hep c from sex?
NO
53
when can one get hep e?
range but | chronic infection - post transplant and immunosuppresed
54
which is the only non-vaccine preventable hep virus?
hep c
55
hep c is acquired from?
blood products
56
what marker is used to diagnose hep c? problems? what to measure instead ?
Anti-HCV antibody rises after 4 weeks. -ALT rises first! measure - HCV RNA
57
treatment for hep c?
everyone who has it gets treatment with: Direct acting antivirals - NS3,4,5 inhibitors (serine) Protease inhibitors
58
which hep virus can you get only if you have hep b?
hep d
59
if one has hep b and d co-infection, can this become chronic?
no
60
if one has hep b and d SUPER infection, can this become chronic?
yes happens in people who already have hep b
61
how to prevent hep d?
hep b vaccine + post exposure prophylaxis
62
which hep b genotypes affect humans?
GT 1 and 2 directly 3 and 4 only IF humans eat undercooked meat
63
which hep virus are pregnanct women at risk of death from?
hep e
64
how to diagnose hep e in 1. immunocompetent 2. immunocompromised ?
1. immunocompetent : anti-hep e antibodies | 2. immunocompromised: hep e RNA
65
which hep virus is associated with extra hepatic manifestation of which neurological signs most important?
hep e
66
treatment/prevention for hep e?
supportive RIBAVIRIN
67
RARE COMPLICATIONS: CNS disease – Bell’s palsy, Guillain Barre, other neuropathy are found in?
hep e

Path - Microbiology (27 decks)

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