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GI > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

How can you use the ratio between ALT/AST to tell the difference between viral and toxic hepatitis?

A
  • viral hepatitis = ALT > AST

- toxic hepatitis = AST > ALT

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2
Q

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

d. recovery

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3
Q

What is the difference between subfulminant and fulminant hepatic failure?

A
  • subfulminant = encephalopathy > 8 weeks

- fulminant = encephalopathy < 8 weeks

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4
Q

T/F: Hepatitis A never evolves to chronic hepatitis?

A

True

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5
Q

What are the 2 current treatment options for Hep C?

A
  • Glecaprevir/Pibrentasvir for 8 weeks

- Sofosbuvir/Velpatasvir for 12 weeks

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6
Q

What 2 types of hepatitis are caused by fecal-oral transmission?

A
  • A and E
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7
Q

How can you tell the difference between Hep D/B coinfection vs. superinfection?

A
  • Coinfection = HBcIgM +

- Superinfection = no HBcIgM present

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8
Q

If you have hepatitis B you are at an increased risk for what type of cancer?

A
  • hepatocellular carcinoma
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9
Q

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

A

b. icteric phase

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10
Q

What drug therapy is used for infants of infected Hep B mothers to reduce vertical transmission?

A
  • Hep B Ig + vaccine (within 12h of birth)
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11
Q

What is the vaccination protocol for Hep B in children?

A
  • 1st dose = at birth
  • 2nd dose = 1-2 mo
  • 3rd dose = 6-18 mo
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12
Q

What type of viral hepatitis is an enveloped DNA virus?

A
  • B
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13
Q

What drug therapy can be used for prevention of Hep B if a patient has had exposure within 48 hrs?

A
  • Hep B immunoglobulin
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14
Q

What is the incubation period for Hepatitis B?

A
  • 30-150 day
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15
Q

75% of cases of Hepatitis C occur in this population.

A
  • Baby boomers
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16
Q

What is the primary form of transmission of hepatitis B?

A
  • Body fluids
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17
Q

At what level of bilirubin will you see jaundice?

A

> 2.5 mg/dL

18
Q

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

A

c. incubation period

19
Q

What was the classic regimen for Hep C and why is it no longer used?

A
  • Interferon + Ribavirin

- no longer used d/t interferon having multiple side effects

20
Q

What serology values confirms an acute Hep C infection?

A

(-) Anti-HCV antibodies

(+) HCV RNA

21
Q

What type of viral hepatitis is associated with GBS?

A
  • E
22
Q

NAC is indicated for acetaminophen blood levels are how high?

A

> 200

23
Q

What is the first line treatment for Hep B? (2 options)

A

Entecavir or Tenofovir

24
Q

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

a. incubation

25
Q

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

a. pre-icteric phase

26
Q

Chronic hepatitis is characterized as greater than how many months?

A

> 6 months

*ALT/AST may remain elevated

27
Q

What is the protocol for Hep C prevention during a needle stick?

A
  • no empiric treatment

- check HCV RNA & AST/ALT at 0, 2 weeks, 4 months, 6 months

28
Q

Hep D can only replicate with coexisting what?

A

Hep B infection

29
Q

What serology study indicates the patient has been vaccinated for Hep B?

A
  • HBsAb +

- everything else negative

30
Q

What hepatitis C genotype is most common in the U.S.?

A
  • genotype 1
31
Q

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

c. convalescence

32
Q

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

A

d. convalescent period

33
Q

What lab study is ordered to obtain a quantitative marker of Hep B viral replication?

A
  • HBV DNA (viral load)

* also used to monitor treatment of chronic HBV infection

34
Q

What is the goal of Hep C treatment?

A
  • to achieve a sustained virologic response

* this means Hep C not detectable in blood

35
Q

Which of the detectable antigens indicate a chronic Hep B infection?

A
  • Hepatitis B envelope antigen (HBeAg)
36
Q

Currently, what is the most common cause of Hepatitis C?

A
  • IVDU
37
Q

What is the treatment for Hepatitis A?

A
  • supportive, usually self-limited
38
Q

What hepatitis E genotypes are strictly human?

A
  • 1 & 2
39
Q

Where in the lifecycle of Hep C do most drugs work?

A
  • they interfere with translation and replication of RNA in the cytoplasm
40
Q

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

b. acute hepatitis

41
Q

Which of the detectable antigens indicate an acute Hep B infection?

A
  • Hepatitis B surface antigen (HBsAg)

GI (7 decks)

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