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microbiology > Viral Hepatitis- Exam IV > Flashcards

Viral Hepatitis- Exam IV Flashcards

1
Q

A clinical syndrome characterized by inflammation of the liver

A

hepatitis

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2
Q

In viral hepatitis, ____ cell death releases ____ which causes ____.

A

hepatocyte; bilirubin; jaundice

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3
Q

A byproduct of heme metabolism in the liver (where heme is detoxified)

A

bilirubin

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4
Q

Where is heme detoxified? What does this create?

A

liver; bilirubin

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5
Q

hepatitis viruses have a strong tropism for the liver and preferentially replicate in the ___.

A

hepatocyte

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6
Q

___% of liver cells are hepatocytes

A

85%

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7
Q

Hepatitis viruses primarily cause:

A

liver disease

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8
Q

Infectious hepatitis is caused by:

A

Hep A and Hep E

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9
Q

“Hit and Run” describes ____ hepatitis

“Hide and Infiltrate” describes ___ hepatitis

A

infectious (A & E)

serum (B, C & D)

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10
Q

How is infectious hepatitis (A&E) transmitted?

A

Fecal-oral

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11
Q

Serum Hepatitis is caused by:

A

Hep B, C, & D

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12
Q

How is serum hepatitis (B, C, & D) transmitted?

A

blood and sexual fluids

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13
Q

What is the nucleic acid composition of Hepatitis A?

A

linear + ssRNA

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14
Q

What virus family does Hepatitis A belong to?

A

picrornaviridae

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15
Q

Hepatitis A causes:

A

infectious hepatitis

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16
Q

Describe the characteristic shape and viral structure of HAV?

A
  • icosahedral, naked capside virus
  • positive strand linear RNA
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17
Q

How is HAV spread?

A

spread by fecal-oral contamination of food, drink, or shelfish

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18
Q

HAV is shed into ____ and into ___ and passes out of the body in ___.

A

bile ducts; intestine; feces

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19
Q

How does HAV kill hepatocytes?

A

DIRECTLY

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20
Q

What is the clinical manifestations of HAV?

A

Usually mild intestinal infectious, but occasionally viremia occurs, leading to liver infection and jaundice

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21
Q

Describe the vaccination for HAV:

A

Killed HAV vaccine, recommended for all in US, especially military, frequent travelers, and staff of care facilities

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22
Q

In highly endemic regions (HAV) , almost all children become:

A

infected in the first few years of life

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23
Q

In endemic regions most children infected with HAV in the first few years of life remain:

A

asymptomatic

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24
Q

Adults from non endemic regions (HAV) who become infected are more likely to:

A

display symptoms

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25
Describe the nucleic acid composition of Hep B:
nicked circular, mostly double stranded DNA
26
What virus family does hep B belong to?
hepadnaviridae
27
Describe the viral genome structure of Hep B:
- enveloped - smallest viral genome of 3200 nucleotides
28
How many nucleotides are present in the viral genome of Hep B?
3200
29
How many distinct viral particles does Hep B contain, describe:
3 distinct viral particles - 22 nm particles - variable tubular/ filamentous particle (22nm) - 42 nm Dane particle (infective form of virus)
30
Which viral particle of Hep B is the infective form of the virus?
Dane particle
31
List the Hep B surface antigens:
L, M, S
32
Which Hep B surface antigen is embedded into the lipid bilayer (envelope)?
S
33
What is the main component of the Hep B lipid bilayer/envelope/dane particle?
HGsAg-S
34
Core antigens of Hep B include:
HBe antigen & HBc antigen
35
Core antigen that is mostly secreted from infected cells and found in the bloodstream, making it a useful marker for HBV infection:
HBeAg
36
The filaments of hep B are enriched for:
HBsAg-L
37
In hep B, both types of 22nm particles are:
empty envelopes
38
Most of the 22nm viral particles of Hep B are:
spherical
39
Reverse transcription in seen in Hep B is performed by:
viral reverse transcriptase
40
Unlike retroviruses, RT in hep B occurs during:
viral assembly
41
Transcription of hep B occurs via:
Host RNA polymerase
42
priming of reverse transcriptase by TP (terminal protein domain) of viral polymerase occurs by:
adding first nucleotide to a tyrosine residue of TP
43
What determine the course of HBV infection?
Cell-mediated immune response
44
What is responsible for killing hepatocytes infected with HBV?
Cytotoxic T-lymphocytes
45
If a liver infected with HBV has an effective cell mediated immune response, what will the outcome be?
acute disease (jaundice and release of enzymes) with resolution
46
If a liver infected with HBV has a limited cell mediated immune response, what will the outcome be?
Chronic disease with mild symptoms leading to either: - fulminant hepatitis - primary hepatocellular carcinoma - cirrhosis
47
What is the agent responsible for the progression of chronic hep B into fulminant hepatitis?
Delta agent
48
The outcomes of acute hepatitis B include: 90% ___ 9% ___ 1% ___
90% resolution 9% HBsAg + for greater than 6 months 1% fulminant hepatitis
49
From the individuals who have had acute HBV infection that results in HBsAg+ antibodies for greater than 6 months, what are the possible outcomes:
1. resolution 2. chronic active hepatitis
50
If a hep B infection progresses to chronic active hepatitis, what are the possible outcomes?
1. cirrhosis 2. hepatic cell carcinoma
51
How does HBV kill hepatocytes?
INDIRECTLY
52
Describe how HBV indirectly kills hepatocytes:
Cytotoxic T-lymphocytes directed against MHC class I proteins bound to viral antigens on hepatocyte surface
53
In addition to cytotoxic T-lymphocytes being directed against MHC class I proteins bound to viral antigens on hepatocyte surface, killing of hepatocytes also occurs by:
cytokine release that promotes inflammation and tissue damage
54
% of infants infected with HBV that becomes chronically infected:
90%
55
Why do 90% of infants become chronically infected with HBV?
immature cell-mediated immune response
56
Why do some cases of chronic HBV progress to hepatocellulr carcinoma?
1. Increased cell division due to regeneration which increases the chances of mutations 2. peroxides and free radicals from CTL killng
57
Increased cell division due to regeneration (increasing the changes of mutation), and peroxides and free radicals from CTL killing may result in:
hepatocellular carcinoma
58
Interpretation of serologic assays for hepatitis B virus: HbsAg: neg Anti-HBs: neg Anti-HBc: neg Anti-Hbe: neg HbeAg: neg Interpretation=
No prior exposure
59
Interpretation of serologic assays for hepatitis B virus: HbsAg: N Anti-HBs: P Anti-HBc: N Anti-Hbe: N HbeAg: N Interpretation=
prior vaccination
60
Interpretation of serologic assays for hepatitis B virus: HbsAg: N Anti-HBs: P Anti-HBc: P Anti-Hbe:P HbeAg: N Interpretation=
prior acute infection, resolved
61
Interpretation of serologic assays for hepatitis B virus: HbsAg: P Anti-HBs: N Anti-HBc: P Anti-Hbe: N HbeAg: P Interpretation=
acute or chronic infection
62
Interpretation of serologic assays for hepatitis B virus: HbsAg: P Anti-HBs: N Anti-HBc: P Anti-Hbe:P HbeAg: N Interpretation=
later stage in chronic infection
63
Discuss the vaccination for Hep B:
vaccination recommended for all infants in US; HbsAg particles produced in yeast
64
Following vaccination, discuss immunity:
passive immunotherapy within 7 days of exposure
65
What may be used as a treatment for Hep B infection?
reverse transcriptase inhibitors (originally anti-HIV drugs)
66
Describe the nucleic acid composition of Hep D:
circular negative sense ss RNA
67
What virus family does hep D belong to?
deltaviridae
68
HDV depends on ____ to replicate
HBV
69
Chronic HBV infection is exacerbated by:
infection with HDV
70
What is the nucleic acid composition of Hep C?
linear + ss RNA
71
What family of viruses does Hep C belong to?
Flaviviridae
72
Is hep C enveloped or non-enveloped?
enveloped
73
Discuss all the modes of transmission of Hep C:
1. blood & sexual fluid 2. mother to fetus via fecal oral route 3. organ transplants
74
How does HCV kill hepatocytes?
INDIRECTLY
75
HCV kills hepatocytes indirectly by:
1. Cytotoxic T lymphocytes directed against MHC class I proteins bound to viral antigens on hepatocyte surface 2. By cytokine release that promotes inflammation and tissue damage
76
Immune complex disease of kidney and other sites- disease outside liver caused by hep C:
mixed cyroglobulinemia
77
Mixed cryglobulinemia is caused by what virus?
Hep C
78
In mixed cryglobulinemia, inflammation and blockage of small and medium blood vessels is caused by:
cryoglobulin deposition
79
Hepatitis C virus acute infection possible outcomes: 15% __ 15% __ 70% __
15% recovery and clearance 15% cirrhosis and rapid onset 70% persistant infection
80
If Hep C virus acute infection results in persistent infection (70%), what next will occur?
chronic hepatitis
81
What are the outcomes of chronic hepatitis caused by Hep C? 6% ___ 20% ___ 4% ___
6% liver failure 20% cirrhosis 4% hepatocellular carcinoma
82
Describe the nucleic acid composition of Hepatitis E:
linear + ssRNA
83
What virus family does Hep E belong to?
Calciviridae
84
How is Hep E virus release?
Not by budding; released as a naked capsid virus
85
Describes the modes of transmission of Hep E:
1. spread in contaminated food & drink (like hep A) 2. human-to-human transmission 3. animal-to-human transmission (zoonosis)
86
For animal to human transmission of Hep E, what is a common source?
Pigs

microbiology (24 decks)

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