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Microbiology > Viral Hepatits (EXAM IV) > Flashcards

Viral Hepatits (EXAM IV) Flashcards

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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
Q

Describe the nucleic acid composition of Hep B:

A

Nicked circular, mostly double-stranded DNA

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26
Q

What family of virus does hepatitis B belong to?

A

Hepadnaviridae

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27
Q

Describe the viral genome structure of Hep B:

A
  • Enveloped
  • Smallest viral genome of 3200 nucleotides
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28
Q

How many nucleotides are present in the viral genome of Hep B?

A

3200

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29
Q

How many distinct viral particles does Hep B contain, describe:

A

3 distinct viral particles
-22nm particle
-Variable tubular/filamentous particle (22 nm)
- 42 nm Dane particle (infective form of virus)

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30
Q

Which viral particle of Hep B is the infective form of the virus:

A

Dane particle

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31
Q

List the hepatitis B surface antigens:

A

L, M, S

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32
Q

Which Hep B surface antigen is embedded in lipid bilayer (envelope)?

A

S

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33
Q

What is the main component of the Hep B lipid bilayer/Envelope/Dane particle:

A

HBsAg-S

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34
Q

Core antigens of Hep B include:

A

HBeAg & HBcAg

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35
Q

Core antigen that is mostly secreted from infected cells and found in the bloodstream, making it a useful marker for HBV infection:

A

HBeAg

36
Q

The filaments of Hep B are enchriched for:

A

HbSAg-L

37
Q

In Hep B, both types of 22nm particles are:

A

Empty envelopes

38
Q

Most of the 22nm viral particles of Hep B are:

A

Spherical

39
Q

The reverse transcription seen in Hep B is performed by:

A

Viral reverse transcriptase

40
Q

Unlike retroviruses, RT in hep B occurs during:

A

Viral assembly

41
Q

Transcription of Hep B occurs via:

A

Host RNA polymerase

42
Q

Priming of reverse transcriptase by TP (Terminal protein domain) of viral polymerase occurs by:

A

Adding first nucleotide to a tyrosine residue of TP

43
Q

What determines the course of HBV infection?

A

Cell-mediated immune response

44
Q

What is responsible for killing hepatocytes infected with HBV?

A

Cytotoxic T lymphocytes

45
Q

If a liver infected with HBV has an effective cell-mediated immune response, what will the outcome be?

A

Acute disease (jaundice & release of enzymes) with resolution

46
Q

If a liver infected with HBV has a limited cell-mediated immune response, what will the outcome be?

A

Chronic disease with mild symptoms leading to either:

-Fulminant hepatitis
-Primary hepatocellular carcinoma
-Cirrhosis

47
Q

What is the agent responsible for the progression of chronic Hep B into fulminant hepatitis?

A

Delta agent

48
Q

The outcomes of acute HBV infection include:

90% _____
9% _____
1% _____

A

90% resolution
9% HBsAg + for greater than 6 months
1% fulminant hepatitis

49
Q

From the individuals who have had acute HBV infection that results in HBsAg + for greater than six months what are the possible outcomes?

A
  1. Resolution
  2. Chronic active hepatitis
50
Q

If a hep B infection progresses to chronic active hepatitis, what are the possible outcomes?

A
  1. Cirrhosis
  2. Hepatic cell carcinoma
51
Q

How does HBV kill hepatocytes?

A

INDIRECTLY

52
Q

Describe how HBV indirectly kills hepatocytes:

A

Cytotoxic T lymphocytes directed against MH class I proteins bound to viral antigens on hepatocyte surface

53
Q

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:

A

Cytokine release that promotes inflammation & tissue damage

54
Q

Percent of infants infected with HBV that become chronically infected:

A

90%

55
Q

Why do 90% of infants infected with HBV become chronically infected?

A

Immature cell-mediated immune response

56
Q

Why does some cases of chronic HBV progress to hepatocellular carcinoma?

A
  1. Increased cell division due to regeneration- increases chances of mutations
  2. Peroxides & free radical from CTL killing
57
Q

Increased cell division due to regeneration, (increasing the chances of mutation) & peroxides & free radicals from CTL killing may result in:

A

Hepatocellular carcinoma

58
Q

Interpretation of serologic assays for Hepatitis B virus:

HbsAg: neg
Anti-HBs: neg
Anti-HBc: neg
Anti-HBe: neg
HBeAg: neg

Interpretation =

A

No prior exposure

59
Q

Interpretation of serologic assays for Hepatitis B virus:

HbsAg: neg
Anti-HBs: pos
Anti-HBc: neg
Anti-HBe: neg
HBeAg: neg

Interpretation =

A

Prior vaccination

60
Q

Interpretation of serologic assays for Hepatitis B virus:

HbsAg: neg
Anti-HBs: pos
Anti-HBc: pos
Anti-HBe: pos
HBeAg: neg

Interpretation =

A

Prior acute infection, resolved

61
Q

Interpretation of serologic assays for Hepatitis B virus:

HbsAg: pos
Anti-HBs: neg
Anti-HBc: pos
Anti-HBe: neg
HBeAg: pos

Interpretation =

A

Acute or chronic infection

62
Q

Interpretation of serologic assays for Hepatitis B virus:

HbsAg: pos
Anti-HBs: neg
Anti-HBc: pos
Anti-HBe: pos
HBeAg: neg

Interpretation =

A

Later stage in chronic infection

63
Q

Discuss the vaccination for HBV:

A

Vaccination recommended for all infants in USA; HBsAg particles produced in yeast

64
Q

Following vaccination against HBV discuss immunity:

A

Passive immunotherapy within 7 days of exposure

65
Q

What may be used as a treatment for Hep B infection:

A

Reverse transcriptase inhibitors (originally anti-HIV drugs)

66
Q

Describe the nucleic acid composition of Hep D:

A

Circular, negative sense, single-stranded RNA

67
Q

What family of viruses does hep D belong to?

A

Deltaviridae

68
Q

HDV depend on ____ to replicate

A

HBV

69
Q

Chronic HBV infection is exacerbated by:

A

Infection with hepatitis D virus

70
Q

Describe the nucleic acid composition of Hepatitis c:

A

Linear, positive sense, single-stranded RNA

71
Q

What family of viruses does hepatitis C belong to?

A

Flaviviridae

72
Q

Is Hep C enveloped or nonenveloped?

A

Enveloped

73
Q

Discuss all the modes of transmission of Hep C:

A
  1. Blood & sexual fluid
  2. Mother to fetus via fecal-oral route
  3. Organ transplants
74
Q

How does HCV kill hepatocytes?

A

INDIRECTLY

75
Q

HCV kills hepatocytes indirectly by:

A
  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
Q

Immune complex disease of kidney & other sites -disease outside the liver; caused by hepatitis C:

A

Mixed cryoglobulinemia

77
Q

Mixed cryoglobulinemia is caused by what virus?

A

Hep C

78
Q

In mixed cryoglobulinemia, inflammation of small & medium vessels is caused by:

A

Cryoglobulin deposition

79
Q

Describe the possible outcomes for Acute infection of Hepatitis C virus:

15% ____
15% ____
70% ____

A

15% recovery & clearance
15% cirrhosis rapid onset
70% persistent infection

80
Q

If acute infection of Hep C virus progresses to persistent infection (70%) what will occur next?

A

Chronic hepatitis

81
Q

What are the outcome of chronic hepatitis cause by hepatitis C?

6% ____
20% ___
4% ____

A

6% liver failure
20% cirrhosis
4% hepatocellular carcinoma

82
Q

Describe the nucleic acid composition of Hepatitis E:

A

Linear + single-stranded RNA

83
Q

What family of viruses does Hepatitis E belong to?

A

Calciviridae

84
Q

How is Hep E virus released?

A

NOT by budding; released as a naked capsid virus

85
Q

Describe the modes of transmission of Hep E:

A
  1. Spread in contaminated food & drink (like Hep A)
  2. Human-to-human transmission
  3. Animal-to-human transmission (zoonosis)
86
Q

For animal-to-human transmission of Hep E, what is a common source?

A

Pigs

Microbiology (22 decks)

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