Virus GI

Question 1

Define Acute Viral Hepatitis Symptoms

Answer 1

• Jaundice: yellowing of the skin and eyes due to increased bilirubin levels
• Dark Urine
• Acholic stool: light or clay-colored stool due to reduction in bile production
• Prodrome: 1-2weeks prior to jaundice –> headache, myalgia, arthralgia, fatigue, nausea, vomiting, pharyngitis, mild fever

Question 2

Define Acute viral hepatitis Biochem levels

Answer 2

Bilirubin levels
- >3mg/dL jaundice
- Commonly 5-20 mg/dL
- Bilirubin in Urine = LIVER DISEASE
Liver enzymes
- ALT, AST elevated higher than other hepatitis

Question 3

Define Chronic viral hepatitis

Answer 3

• Heptatitis which does NOT resolve within 6 months

- PREDISPOSES to hepatocellular carcinoma and cirrhosis

Question 4

Define Fulminant Viral hepatitis

Answer 4

• RAPID, severe hepatitis
• Massive hepatic Necrosis
• ENCEPHALOPATHY (confusion, disorientation, coma)
• Edema
  Complications: cerebral edema, brainstem compression, GI bleeding)

Question 5

What types of hepatitis end in chronic infection?

Answer 5

Hep B, C, D

Question 6

What types of hepatitis are transmitted by body fluid?

Answer 6

Hep B, C, D

Question 7

What types of hepatitis are transmitted by fecal-oral route?

Answer 7

A, E

Question 8

What is HBeAg indicative of?

Answer 8

Hepatitis E antigen indicates ACTIVE VIRAL replication (very infectious person)

Question 9

What are the two form of Chronic HBV infections

Answer 9

Chronic Replicative indicated by HBeAg (Virus is replicated)
Chronic Non-replicative indicated by absence of HBeAg indicating that virus is still present, but not removed from system

Question 10

Define Superinfection

Answer 10

Start off with an infection of HBV and then later layer on HDV
- superinfection is worse than a co-infection between HBV and HDV

Question 11

What is the best pre- or post- exposure prophylaxis against hep B virus for no known history of exposure?

Answer 11

Hepatitis B vaccine

Question 12

What is the best pre- or post- exposure prophylaxis against hep B virus for a neonate born to a hep B virus infected mom

Answer 12

Hepatitis B vaccine and hepatitis B immune globulin (HBIG)

Question 13

What is the best pre- or post- exposure prophylaxis against hep B virus for adult with risk factors for exposure and no active dx

Answer 13

Hepatitis B vaccine

Question 14

Compare Viral Gastroenteritis vs. Bacterial Gastroenteritis

Answer 14

Viral gastroenteritis:
- 1-3 day incubation
- vomiting is Prominent and can be only presenting feature
- Diarrhea is common; nonbloody
- Diagnosis enzyme immunoassays
Bacterial Gastoenteritis
- incubation = hours to 7 days
- Vomiting is common in bacteria PRODUCING preformed toxins
- Diarrhea is prominent and frequently BLOODY with agents causing inflammation
- Diagnosis is made via stool specimens