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Viral Hepatits (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 ____ and preferentially replicate in the ____

A

Liver; 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 & Hep E

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9
Q

“Hit & run” describes ____ hepatitis

“Hide & 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, Hep C, Hep D

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12
Q

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

A

Blood & sexual fluids

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13
Q

Describe the nucleic acid composition of Hep A:

A

Linear, + sense, single-stranded RNA

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14
Q

What virus family does hepatitis A belong to?

A

Picornaviridae

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15
Q

Hepatitis A causes:

A

Infectious hepatitis

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16
Q

Describe the characteristic shape & viral structure of HAV:

A
  • Icosahedral, naked capsule
  • Positive strand linear RNA
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17
Q

How is HAV spread?

A

Spread by fecal-oral contamination of food, drink or shellfish

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18
Q

HAV is shed into _____ and into _____ & 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 infection?

A

Usually mild intestinal infection, occasionally viremia occurs, leading to liver infection & jaundice

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21
Q

Describe the vaccine for HAV:

A

Killed HAV vaccine, recommended for all in U.S., especially military, frequent travelers & 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 family of virus does hepatitis 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 -22nm particle -Variable tubular/filamentous particle (22 nm) - 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 hepatitis B surface antigens:
L, M, S
32
Which Hep B surface antigen is embedded in lipid bilayer (envelope)?
S
33
What is the main component of the Hep B lipid bilayer/Envelope/Dane particle:
HBsAg-S
34
Core antigens of Hep B include:
HBeAg & HBcAg
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 enchriched 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
The reverse transcription 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 determines 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 & 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 HBV infection 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 + for greater than six 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 MH 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 hepatocyte also occurs by:
Cytokine release that promotes inflammation & tissue damage
54
Percent of infants infected with HBV that become chronically infected:
90%
55
Why do 90% of infants infected with HBV become chronically infected?
Immature cell-mediated immune response
56
Why does some cases of chronic HBV progress to hepatocellular carcinoma?
1. Increased cell division due to regeneration- increases chances of mutations 2. Peroxides & free radical from CTL killing
57
Increased cell division due to regeneration, (increasing the chances of mutation) & peroxides & 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: neg Anti-HBs: pos Anti-HBc: neg Anti-HBe: neg HBeAg: neg Interpretation =
Prior vaccination
60
Interpretation of serologic assays for Hepatitis B virus: HbsAg: neg Anti-HBs: pos Anti-HBc: pos Anti-HBe: pos HBeAg: neg Interpretation =
Prior acute infection, resolved
61
Interpretation of serologic assays for Hepatitis B virus: HbsAg: pos Anti-HBs: neg Anti-HBc: pos Anti-HBe: neg HBeAg: pos Interpretation =
Acute or chronic infection
62
Interpretation of serologic assays for Hepatitis B virus: HbsAg: pos Anti-HBs: neg Anti-HBc: pos Anti-HBe: pos HBeAg: neg Interpretation =
Later stage in chronic infection
63
Discuss the vaccination for HBV:
Vaccination recommended for all infants in USA; HBsAg particles produced in yeast
64
Following vaccination against HBV 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, single-stranded RNA
67
What family of viruses does hep D belong to?
Deltaviridae
68
HDV depend on ____ to replicate
HBV
69
Chronic HBV infection is exacerbated by:
Infection with hepatitis D virus
70
Describe the nucleic acid composition of Hepatitis c:
Linear, positive sense, single-stranded RNA
71
What family of viruses does hepatitis C belong to?
Flaviviridae
72
Is Hep C enveloped or nonenveloped?
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 & damage
76
Immune complex disease of kidney & other sites -disease outside the liver; caused by hepatitis C:
Mixed cryoglobulinemia
77
Mixed cryoglobulinemia is caused by what virus?
Hep C
78
In mixed cryoglobulinemia, inflammation of small & medium vessels is caused by:
Cryoglobulin deposition
79
Describe the possible outcomes for Acute infection of Hepatitis C virus: 15% ____ 15% ____ 70% ____
15% recovery & clearance 15% cirrhosis rapid onset 70% persistent infection
80
If acute infection of Hep C virus progresses to persistent infection (70%) what will occur next?
Chronic hepatitis
81
What are the outcome of chronic hepatitis cause by hepatitis C? 6% ____ 20% ___ 4% ____
6% liver failure 20% cirrhosis 4% hepatocellular carcinoma
82
Describe the nucleic acid composition of Hepatitis E:
Linear + single-stranded RNA
83
What family of viruses does Hepatitis E belong to?
Calciviridae
84
How is Hep E virus released?
NOT by budding; released as a naked capsid virus
85
Describe 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 (22 decks)

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