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Infection > week 8 - hepatitis/HPV+cancer > Flashcards

week 8 - hepatitis/HPV+cancer Flashcards

1
Q

causes of hepatitis

A

infectious

non infectious - alcohol, drug uses, auto immune disorders

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2
Q

signs of hepatitis

A

jaundice
fever
malaise
upper abdominal discomfort

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3
Q

what clinical signs might you see during examination

A

spider naevi
jaundice
splenomalgy
hepatomalgy

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4
Q

How is HAV transmitted?

A

faecal-oral

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5
Q

what family is Hep A

A

heptoviridae

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6
Q

what is the pathogenesis of hep A

A

invades body by ingestion
multiplies in GI and moves to liver
enters intestine w/ bile and appears in exxcrete
causing liver damage

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7
Q

what family is Hep E

A

Calcivirus - like

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8
Q

where is Hep contracted from

A

raw shell fish
sexual contact
contaminated food/water

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9
Q

How is HBeAg produced, and what is it a good measure of?

A

Produced from breakdown of core antigen from infected liver cells Marker of infectivity

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10
Q

How is HBV transmitted?

A

parenteral - blood transfusion, infected needles

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11
Q

How is HBV transmitted?

A

parenteral

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12
Q

How is HDV transmitted?

A

parenteral

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13
Q

How many genotypes for Hepatitis A

A

4

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14
Q

What antigen on HBV used as a marker for infection

A

HBsAg

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15
Q

What are the different categories of transmission for Hepatitis B

A

Horizontal
Vertical

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16
Q

What is the horizontal transmission for Hepatitis B

A

Sexual contact
Blood transfusion
re-use of contaminated needles

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17
Q

What is the horizontal transmission for Hepatitis B

A

Sexual contact
Blood transfusion
re-use of contaminated needles

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18
Q

What 3 FDA approved drugs for hepatitis B

A
  • Interferon-alpha 2b
  • Hepsera
  • Lamivudine
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19
Q

What antigen on HBV used to document recovery or immunity to HBC infection

A

HBsAb (hepatitis B virus antibody)

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20
Q

What apperance of hepatocytes in chronic hepatitis B

A

Ground glass

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21
Q

What are decoy particles in Hepatitis B

A

HBsAg containing particles released into serum that try to distract immune system from HPV virus

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22
Q

how are decoy particles used clinically

A

used to create vaccines

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23
Q

What are some extra-hepatic complications of Hepatitis A

A

Arthritis
Myocarditis
Renal failure

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24
Q

What are some functions of the liver

A

Bile production
filtration of toxins
synthesis of clotting factors

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25
Q

What are some infectious causes of hepatitis

A

Viral
Bacteria
Fungal
Parasitic

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26
Q

What are some non infectious causes of hepatitis

A

Alcohol
Drugs
Autoimmune
metabolic diseases

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27
Q

What are the 2 consequences of Hepatitis B and Hepatitis D

A

Coinfection
Superinfection

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28
Q

What are the different antigens for Hepatitis B

A

HBsAg-Surface antigen
HBcAg-Core antigen
HBeAg-Envelope antigen

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29
Q

What are the different markers that can be investigated in HCV

A

HCV antibody
HCV-RNA
HCV-antigen

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30
Q

What are the high risk groups for Hepatitis B

A

Babies of mothers with chronic HBV
Intravenous drug users
people with multiple sex partners
Hemophiliacs or other patients requiring blood treatment
Health care personnel who are in contact with blood

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31
Q

What are the possible outcomes of Hepatitis B infection

A

Chronic infection leading to chronic hepatitis
Chronic hepatitis leading to cirrhosis
Cirrhosis causing hepatocellular carcinoma or liver failure

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32
Q

What are the signs and symptoms of acute HCV

A

Decreased appetite
Fatigue
nausea
Muscle or joint pain
jaundice
weight loss

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33
Q

What are the signs and symptoms of chronic HCV

A

Fatigue
Fatty liver
Cirrhosis
hepatocellular carcinoma
easy bruising
hepatic encephalopathy

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34
Q

What are the treatments for HCV

A

Interferon
Ribavirin

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35
Q

What conditions does Hepatitis B cause

A

acute and chronic Hepatitis
Cirrhosis
Hepatocellular carcinoma

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36
Q

What does development of antibodies against HBsAg suggest

A

Resolution of chronic inflammation

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37
Q

What does HBeAg indicate

A

Active replication of virus and infectiveness

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38
Q

What does HBV-DNA presence indicate

A

Active replication of HBV virus

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39
Q

What does presence of Anti-HBe suggest

A

Virus no longer replicating however patient can still be positive for HBsAg

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40
Q

What genetic information does Hepatitis D have

A

negative sense single stranded RNA (-ssRNA)

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41
Q

What genetic information in HCV

A

single stranded RNA (ssRNA)

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42
Q

What hepatitis is not enveloped

A

Hepatitis A and Hepatitis E

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43
Q

What Hepatitis transmitted via fecal-oral route

A

Hepatitis A
Hepatitis E

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44
Q

What Hepatitis transmitted via fecal-oral route

A

Hepatitis A
Hepatitis E

45
Q

What is a coinfection

A

simultaneous infection of a host by multiple pathogen species

46
Q

What is an occult HBV infection

A

presence of HBV DNA in liver or undetectable HBV DNA in serum

47
Q

What is HCV antibody used for

A

Diagnosis of hepatitis C infection

48
Q

What is hepatitis

A

Inflammation of liver

49
Q

What is involved in the replication of Hepatitis B

A

Reverse transcriptase

50
Q

What is spider naevi

A

swollen blood vessels found slighly beneath skin surface
central red spot and reddish extensions

51
Q

What is the difference between anti-HBc IgM and anti-HBc IgG?

A

IgM indicates current or acute infection (<6 months duration) IgG indicates chronic infection (>6 months)

52
Q

What is the hepatitis B prevention for newborns

A

hepatitis B vaccine and hepatitis B immune globulin given within 12 hours of birth and 2nd dose of vaccine given at 1-2 months and 3rd dose no later than 6 months

53
Q

What is the incubation period for HCV

A

1-26 weeks

54
Q

What is the incubation period of Hepatitis A

A

2-6 weeks

55
Q

What is the incubation period of Hepatitis B

A

60-90 days

56
Q

What is the main use of HCV-RNA in diagnostics

A

Monitor response to antiviral therapy

57
Q

What is the pathogenesis of HCV

A

Virus enters and uncoats in cytoplasm
translation and processing of genetic material occurs
replicative intermediate is formed which then also undergoes translation
virus particle becomes assembled

58
Q

What is the pathogenesis of HBV

A

HBV replicates to produce antigen decoy particle through the use of an RNA intermediate
one of the mRNA of HBV replicated with reverse transcriptase leading to DNA formation
DNA integrated into host genome leading to carrier state

59
Q

What is the prevention for HBV-HDV coinfection

A

pre or post exposure prophylaxis to prevent HBV infection

60
Q

What is the prevention for HBV-HDV superinfection

A

education to reduce risk behaviours

61
Q

What is the serologic course of HBV-HDV coinfection

A

IgM anti-HDV increases and decreases
Anti-HBs slowly increase
Total Anti-HDV increased and decreased

62
Q

what is superinfection

A

develop chronic HCV high risk of chronic liver disease

63
Q

What is the use of HBsAg marker

A

Acute as well as chronic carriers
present in symptomatic patient suggests acute HBV infection

64
Q

What is the use of IgM HBc Ag marker

A

acute HBV infection

65
Q

What is the use of marker IgM HAV

A

Diagnosis of HAV acute infection

66
Q

What is the vaccination course for Hepatitis B

A

3 vaccine injections
2nd injection given at least 1 month after 1st dose and 3rd injection given 6 months after 1st dose

67
Q

What is the whole virus of Hepatitis B called

A

Dane particle

68
Q

What marker is the most useful in identification of HBV

A

Serum Anti HBc

69
Q

What type of virus is Hepatitis B

A

Hepadnavirus

70
Q

What type of virus is Hepatitis C

A

Flavivirus

71
Q

When can you only contract Hepatitis D

A

In the presence of HBV

72
Q

When does HBeAg seroconversion occur

A

When people infected with HBeAg-positive form virus develop antibodies against HBeAg

73
Q

Where is poor response for hepatitis B prevention seen in

A

Age>40
obesity
smoking
alcoholics
advanced liver disease

74
Q

Where is the concentration of Hepatitis B highest in body fluids

A

Blood
serum
Wound exudates

75
Q

Where is the concentration of Hepatitis B Low/not detectable in body fluids

A

urine
Faeces
Sweat
tears
breast milk

76
Q

Where is the concentration of Hepatitis B moderate in body fluids

A

Semen
Vaginal fluid
Saliva

77
Q

Which 2 Hepatitis viruses do not increase the risk for Hepatocellular Carcinoma

A

HAV and HEV

78
Q

what is the pathogenesis of HPV

A

hijacks host cella nd makes viral E6 E7 proteins which can cause cancer

79
Q

what does E6 protein do

A

binds to p53 tumour suppressor and increase growth

80
Q

what does E7 do

A

it has an anti-apoptotic by mutations in p53

81
Q

what is condylomata acuminate

A

benign anogenital warts caused by HPV 6 and 11

82
Q

what two HPV strains increase cervical cancers

A

HPV 16 and 18

83
Q

what is HPV 16 linked to

A

squamous cell carcinoma

84
Q

what is HPV 18 linked to

A

adenocarcinoma

85
Q

what are risk factors for HPV

A

found age at first intercourse
smoking
immunodeficiency

86
Q

what does CIN stand for

A

cervical intraepithelial neoplasia

87
Q

what is a koilocyte

A

a squamous epithelial cell that has undergone several structural changes due to infection by HPV

88
Q

what is used to remove abnormal cells from cervix

A

LEEP - loop electrosurgical excision procedure

89
Q

what is a oncogene

A

genetic material w/ ability to cause cancer

90
Q

what causes herpes

A

HSV 1 or 2 virus

91
Q

After primary infection in herpes where does the virus remain dormant

A

Ganglion neurons

92
Q

How many grades in CIN grading

A

3

93
Q

In which cells does herpes replicate

A

nerve cells

94
Q

What can go wrong if HPV not treated

A

Can be transmitted to sex partners and newborns
Warts may grow and spread
may cause cervical cancer

95
Q

What prevention can be done against cervical neoplasia

A

Vaccination of young women against HPV infections

96
Q

What are some factors that can reactivate herpes

A

Stress
Trauma
immunodeficiency

97
Q

What are the risk factors for HPV

A

damaged skin
immunodeficiency
unprotected sex
uncircumcised males
number of lifetime sexual partners

98
Q

What herpes associated with oral herpes

A

HSV-1

99
Q

What herpes associated with Genital herpes

A

HSV-2

100
Q

What is a colposcopy

A

Examination of the vagina and cervix with a colposcope, a magnifying instrument

101
Q

What is cervical intraepithelial neoplasia

A

abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer

102
Q

What is CIN grading

A

grading system used to describe abnormal epithelial cells and determine there specimen quality

103
Q

What is the incubation period of HPV

A

3-4 months

104
Q

What is the pathophysiology of Cervical cancer

A

HPV infection of basal layer
Viral replication
infected cells move and spread
Viral DNA integration into host genome leading to uncontrolled viral production

105
Q

What is the pathophysiology of herpes

A

Virus enter body through mucosal surfaces
Virus invade,spread and replicate in nerve cells
After primary infection, virus remains dormant in ganglion neurons
triggered by various factors and then spreads to unusual sites

106
Q

What is the treatment for Herpes

A

Antivirals

107
Q

What layer of epithelia do HPV infections occur

A

Basal cell layer

108
Q

What testing available for herpes

A

Visual exam
blood test

109
Q

What type of genetic information does Human Papillomavirus have

A

Double stranded circular

Infection (8 decks)

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