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GI > viral hepatitis overview and prevention > Flashcards

viral hepatitis overview and prevention Flashcards

1
Q

HAV: source

A

oral

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2
Q

HBV: source

A

blood/blood-derived, body fluids

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3
Q

HCV: source

A

blood/blood-derived

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4
Q

HAV transmission route

A

fecal-oral

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5
Q

HBV transmission route

A

percutaneous, permucosal

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6
Q

HCV transmission route

A

percutaneous, permucosal

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7
Q

HAV: chronic infxn?

A

no

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8
Q

HBV: chronic infxn?

A

yes

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9
Q

HCV: chronic infxn?

A

yes

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10
Q

HAV: acute liver failure?

A

yes

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11
Q

HBV: acute liver failure?

A

yes

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12
Q

HCV: acute liver failure?

A

no

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13
Q

HAV: general prevention?

A

pre/post-exposure immunization, immune globulin

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14
Q

HBV: general prevention?

A

pre/post-exposure immunization, immune globulin

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15
Q

HCV: general prevention?

A

donor screening, risk behavior modification

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16
Q

signs of acute liver dysfunction

A

yellow eyes/skin, abdominal pain, pale stools, dark urine

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17
Q

hepatitis A risk factors

A

travel to endemic areas, sexual contact, contaminated food, contact with infected people, handling non-human primates, homelessness. highest risk: injecting or non injecting drug use, unstable housing/homeless, MSM, incarceration, liver disease

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18
Q

HBV risk factors

A

IV drug users, blood transfusions, household contact with infected individuals, healthcare workers, patients undergoing dialysis

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19
Q

HCV risk factors

A

blood transfusions, healthcare workers, multiple sex partners, IV drug users, healthcare workers, piercing/tattooing

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20
Q

chronic complications of viral hepatitis if left untreated

A

hepatocellular carcinoma, end stage liver disease

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21
Q

viral hepatitis risk reduction

A

hygiene, universal precautions, needle exchange

22
Q

adult vaccination for hepatitis A

A

non-IVDU, homelessness, work-related, contact with international adoptee, settings, HIV, MSM, chronic liver disease, travel, pregnancy, IVDU

23
Q

adult vaccination for hepatitis B

A

all adults 19-59 should get vaccinated. adults 60+ with risk factors should get vaccinated. adults 60+ may get vaccinated without known risk factors.

24
Q

hepatitis A childhood immunization

A

> 12 months. 2 dose series, 6 months apart

25
Q

hepatitis B childhood immunization

A

birth, 1-2 mo, 6-18 mo (0,1,6)

26
Q

HAV pre exposure prophylaxis: when should you get VACCINE for travel

A

healthy, >6 months of age, any time pre-departure

27
Q

special note for infants 6-12 months in HAV pre exposure prophylaxis

A

pre-exposure vaccine does not count towards standard childhood immunization.

28
Q

when should you get IMMUNOGLOBULIN for travel HAV pre exposure prophylaxis

A

infants <6 months

29
Q

when should you get immunoglobin + vaccine for travel HAV exposure pre prophylaxis

A

> 40 years old, CLD, immunocompromised, travel in <2 weeks

30
Q

dose of IG for <1 month of travel

A

0.1 mL/kg IM

31
Q

dose of IG for 1-2 months of travel

A

0.2 mL/kg IM

32
Q

dose of IG for >2 months of travel

A

0.2 mL/kg IM, repeat q2months

33
Q

when to initiate drugs in pregnancy to prevent HBV transmission based on a number

A

HBV DNA >200,000

34
Q

when to start drugs in pregnancy to prevent HBV transmission based on time

A

28-32 weeks gestation

35
Q

which drugs for pregnancy to prevent HBV transmission

A

lamivudine, telbivudine, tenofovir DF

36
Q

how long to continue HBV medications post partum

A

0-3 months, breastfeeding is not contraindicated. monitor every 3 months post DC for 6 months

37
Q

how soon to give IG or vaccine for HAV post exposure

A

2 weeks

38
Q

when to give IG for HAV post exposure

A

<12 months, >40 years, immunocompromisd, CLD, vaccine allergy

39
Q

dose of IG for HAV post exposure

A

0.1 mL/kg IM

40
Q

when to give vaccine for HAV post exposure

A

12 months-40 years old, healthy, single dose

41
Q

when to give HBV post exposure prophylaxis

A

perinatal, sexual, health care worker

42
Q

infants born to HBV infected mothers should receive ____

A

HBIG and HBV vaccine both within 12 hours of birth. should additionally receive vaccine at 1 and 6 months

43
Q

people exposed to HBV through sexual contact should receive what prophylaxis

A

HBIG within 14 days, HBV vaccine at 0, 1, 6 months

44
Q

HCW exposed to HBV should receive what prophylaxis

A

HBIG within 24 hours, HBV vaccine within 7 days, complete series or 2nd dose of HBIG

45
Q

risks for HBV reactivation

A

chemo, stem cell transplant, immunosuppression, HCV DAA therapy

46
Q

for moderate and high risk groups to HBV reactivation, how long to give prophylactic treatment

A

6-12 months

47
Q

which agents are preferred for HBV reactivation prophylaxis

A

tenofovir and entecavir

48
Q

which immunosuppression drugs have a high risk of HBV reactivation

A

B-cell depleting: rituximab

49
Q

which immunosuppression drugs have a moderate risk of HBV reactivation

A

TNF alpha inhibitors: adalimumab

50
Q

which immunosuppression drugs have a low risk of HBV reactivation

A

oral steroids <1 week, prednisone <10 mg for >4 weeks, intra-articular steroids. no prophylaxis indicated.

51
Q

what is a black box warning for all HCV medications

A

HBV reactivation

52
Q

hepatitis C prevention?

A

avoidance, monitoring.

GI (15 decks)

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