Virology10

Question 1

T or F
HBc antigen can be found in blood
While Hbe i can’t detect it

Answer 1

False
We should look for the anti HBc
It’s not soluble
Hbe is soluble and we can detect it

Question 2

Window period is :

Answer 2

The gap between the disappearance of the sAg and the formation of antibody

Question 3

State the case of each of the following patients:

HbsAg         Anti-Hbs        Anti-HBc
Negative     Negative       Negative
Negative     Positive         Negative
Negative     Positive         Positive
Positive       Negative      IgM pos
Positive       Negative     IgG positive

Answer 3

Susceptible
Vaccinated
Past infection
Acute infection
Chronic infection

Question 4

Stages of hepatitis B exacerbation:

Answer 4

Immune tolerant: viral load is high and we have HBe(soluble, indicator), normal LFTs
Inmune clearance: lowering of viral load and HBs become to disappear, increasing 5-fold of LFTs (not the case for HepC) , immunopathological damage
Immune control: seroconversion of HBe antigen, viral load is almost null

Immune active: high LFTs and high viral load.

Question 5

Causes of reactivation of hepB (immune active):
1-
2-
3-

Answer 5

1- hepD
2- immunosuppresion(HIV)
3- stress

Question 6

HepC
Fam:
Envelope:
Genome:

Answer 6

Flavivirus
Enveloped
+ ss RNA

Question 7

Hep B risk of infection as an infant is to —— while as an adult ——-

Answer 7

Develop adulthood chronic disease
And to develop hepatocarcinoma
95% is the percentage to recover fully (good)

Question 8

T or F

Hep B and C don’t have extra hepatic manifestations

Answer 8

False they have (rash , vasculitis, arthritis, glomerulo nephritis)

Question 9

MOT of hepC:

Answer 9

Contaminated blood
Snorting (injury of nasal mucosa in drug dealers) (epistaxis)
Darb l haidar

Question 10

Genotypes in hepatitis C are called—– and the most aggressive one is—–

Answer 10

Clades

1b

Question 11

In religous rituals what infectious agents should be asked:

Answer 11

The ones transmitted by body fluids
HIV
B
C
Syphilis

Question 12

Role of NS5A protein:

Answer 12

Inhibits apoptosis and this will lead to more cytokine release and consequently more damage (immune-mediated cytolysis)

Question 13

Management of HCV infection:

Answer 13

Ask for serum test to look for Anti-HCV

HCV genotyping to know which genotype and treat upon the result

Question 14

Characteristics of chronic HCV:

Answer 14

Not a very high LFTs (like in B)
80% byaamlu chronic
20% mn l acute hepatitis hene HCV

Question 15

T or F

HepC causes hepatocarcinoma

Answer 15

True

It constitutes 25% of the hepatocarcinoma patients around the world

Question 16

T or F

Cirrhosis will happen after 10 years of infection with hepC

Answer 16

False

After 20-30

Question 17

Highly predisposed to chronic hepC:
1-
2
3
4
5
6

Answer 17

Older than 40
Alcohol
HIV-HBV
Immunosuppresion
Diabetes or obesity
Schistosomiasis ( bilharzia) le met feha abd l halim hafez allah yrham ruhu

Question 18

All pateints should be treated(after hepC infection) except:

Answer 18

Pregnant
Liver transplant list
End of life ( baadelu 6 months la ymut)

Question 19

Sustained viral remission:

Answer 19

After 4 months of completing treatment we do pcr if it’s negative then i cleared the virus from the body

Question 20

Tx for hepC

Answer 20

1-Interferon alpha with PEG (polyethylene glycol) (provide long half life)
2-We can add ribavirin (as synergistic) (discontinued because of it’s side effects)
3- Direct acting antivirals
4- we should always take into consideration genotype- renal status and medications

Question 21

HepD

Genus:
Fam:
Envelope:
Genome:
Active or defective:
Surface antigen:

Answer 21

Deltavitus (D for Delta)
No fam
Enveloped
Ss- circular RNA
Defective ( as it's name D for defective)
HBsAg (mtl men ya helu?)

Question 22

T or F

Hepatitis D can’t infect unless it’s with B, and this will cause very severe hepatitis

Answer 22

True

Question 23

MOT of hep D

Answer 23

Same as B
Coinfection
Superinfection

Question 24

T or F

Hep E is same as A but it doesn’t cause fulminant hepatits

Answer 24

False

It causes fulminant hepatitis especially in pregos

Question 25

Varicella causes—– and can be severe in pregnant woman.

Answer 25

Pneumonia

Question 26

T or F

Both hep A and E don’t have vaccines

Answer 26

False

Hep A has while E doesn’t