Viral Hepatitis Flashcards
How can you use the ratio between ALT/AST to tell the difference between viral and toxic hepatitis?
- viral hepatitis = ALT > AST
- toxic hepatitis = AST > ALT
Choose the best answer for the following serologic profile
HBsAg -
Anti-HBc IgM -
Total Anti-HBc antibodies +
Anti-HBs antibodies +
a. incubation
b. acute hepatitis
c. convalescence
d. recovery
d. recovery
What is the difference between subfulminant and fulminant hepatic failure?
- subfulminant = encephalopathy > 8 weeks
- fulminant = encephalopathy < 8 weeks
T/F: Hepatitis A never evolves to chronic hepatitis?
True
What are the 2 current treatment options for Hep C?
- Glecaprevir/Pibrentasvir for 8 weeks
- Sofosbuvir/Velpatasvir for 12 weeks
What 2 types of hepatitis are caused by fecal-oral transmission?
- A and E
How can you tell the difference between Hep D/B coinfection vs. superinfection?
- Coinfection = HBcIgM +
- Superinfection = no HBcIgM present
If you have hepatitis B you are at an increased risk for what type of cancer?
- hepatocellular carcinoma
In this phase of acute viral hepatitis, the patient has jaundice, dark urine, and light stool. He also has pruritus, weight loss, fatigue. His ALT/AST are now >10x ULN.
a. pre-icteric phase
b. icteric phase
c. incubation period
d. convalescent period
b. icteric phase
What drug therapy is used for infants of infected Hep B mothers to reduce vertical transmission?
- Hep B Ig + vaccine (within 12h of birth)
What is the vaccination protocol for Hep B in children?
- 1st dose = at birth
- 2nd dose = 1-2 mo
- 3rd dose = 6-18 mo
What type of viral hepatitis is an enveloped DNA virus?
- B
What drug therapy can be used for prevention of Hep B if a patient has had exposure within 48 hrs?
- Hep B immunoglobulin
What is the incubation period for Hepatitis B?
- 30-150 day
75% of cases of Hepatitis C occur in this population.
- Baby boomers
What is the primary form of transmission of hepatitis B?
- Body fluids
At what level of bilirubin will you see jaundice?
> 2.5 mg/dL
In this phase of acute viral hepatitis, the virus is detectable in the blood but the patient is asymptomatic.
a. pre-icteric phase
b. icteric phase
c. incubation period
d. convalescent period
c. incubation period
What was the classic regimen for Hep C and why is it no longer used?
- Interferon + Ribavirin
- no longer used d/t interferon having multiple side effects
What serology values confirms an acute Hep C infection?
(-) Anti-HCV antibodies
(+) HCV RNA
What type of viral hepatitis is associated with GBS?
- E
NAC is indicated for acetaminophen blood levels are how high?
> 200
What is the first line treatment for Hep B? (2 options)
Entecavir or Tenofovir
Choose the best answer for the following serologic profile
HBsAg +
Anti-HBc IgM +/-
Total Anti-HBc antibodies +/-
Anti-HBs antibodies -
a. incubation
b. acute hepatitis
c. convalescence
d. recovery
a. incubation
In this phase of acute viral hepatitis, the patient begins to have non-specific symptoms. Viral titers peak and ALT/AST rise.
a. pre-icteric phase
b. icteric phase
c. incubation period
d. convalescent period
a. pre-icteric phase
Chronic hepatitis is characterized as greater than how many months?
> 6 months
*ALT/AST may remain elevated
What is the protocol for Hep C prevention during a needle stick?
- no empiric treatment
- check HCV RNA & AST/ALT at 0, 2 weeks, 4 months, 6 months
Hep D can only replicate with coexisting what?
Hep B infection
What serology study indicates the patient has been vaccinated for Hep B?
- HBsAb +
- everything else negative
What hepatitis C genotype is most common in the U.S.?
- genotype 1
Choose the best answer for the following serologic profile
HBsAg -
Anti-HBc IgM +
Total Anti-HBc antibodies +
Anti-HBs antibodies -
a. incubation
b. acute hepatitis
c. convalescence
d. recovery
c. convalescence
In this phase of acute viral hepatitis, symptoms gradually resolve and antibody levels rise.
a. pre-icteric phase
b. icteric phase
c. incubation period
d. convalescent period
d. convalescent period
What lab study is ordered to obtain a quantitative marker of Hep B viral replication?
- HBV DNA (viral load)
* also used to monitor treatment of chronic HBV infection
What is the goal of Hep C treatment?
- to achieve a sustained virologic response
* this means Hep C not detectable in blood
Which of the detectable antigens indicate a chronic Hep B infection?
- Hepatitis B envelope antigen (HBeAg)
Currently, what is the most common cause of Hepatitis C?
- IVDU
What is the treatment for Hepatitis A?
- supportive, usually self-limited
What hepatitis E genotypes are strictly human?
- 1 & 2
Where in the lifecycle of Hep C do most drugs work?
- they interfere with translation and replication of RNA in the cytoplasm
Choose the best answer for the following serologic profile
HBsAg +
Anti-HBc IgM +
Total Anti-HBc antibodies +
Anti-HBs antibodies -
a. incubation
b. acute hepatitis
c. convalescence
d. recovery
b. acute hepatitis
Which of the detectable antigens indicate an acute Hep B infection?
- Hepatitis B surface antigen (HBsAg)
