B5-027 Hepatic Viruses Flashcards

1
Q

RNA picornavirus

A

HAV

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2
Q

DNA hepadenavirus

A

HBV

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3
Q

RNA flavivirus

A

HCV

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4
Q

RNA deltavirus

A

HDV

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5
Q

RNA hepevirus

A

HEV

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6
Q

transmission route for HAV

A

fecal oral

shellfish, travelers, daycares

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7
Q

transmission route HBV

A

parenteral (Blood)
sexual (bedroom)
perinatal (Birth)

3 Bs, HBV

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8
Q

transmission route of HCV

A

blood

IV drug use, transfusion

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9
Q

transmission route of HDV

A

parenteral
sexual
perinatal

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10
Q

transmission route of HEV

A

fecal oral

waterbourne

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11
Q
  • is acute and self limiting in adults
  • can be asymptomatic in children
A

HAV

A= acute, asymptomatic

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12
Q
  • intially presents like serum sickness (fever, arthralgias, rash)
  • may progress to carcinoma

2

A

HBV, HDV

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13
Q

may progress to cirrhoisis or carcinoma

A

HCV

C=cirrhosis, carcinoma

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14
Q

fulminant hepatitis in pregnant patients

A

HEV

E=expectant mothers

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15
Q

high mortality in pregnant patients

A

HEV

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16
Q

pose of risk of progressing to HCC

3

A

HBV
HCV
HDV

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17
Q

adults mostly experience full resolutions, but neonates have a far worse prognosis

A

HBV

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18
Q

HDV after HBV is called

A

superinfection

poor prognosis

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19
Q

HDV with HBV is called

A

coinfection

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20
Q

biopsy shows

  • hepatocyte swelling
  • monocyte infiltration
  • coucilman bodies
A

HAV

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21
Q

biopsy shows

  • granular eosinophilic “ground glass” appearance
  • cytotoxic T cells

2

A

HBV, HDV

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22
Q

biopsy shows

lymphoid aggregates with focal areas of macrovesicular steatosis

A

HCV

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23
Q

biopsy shows

patchy necrosis

A

HEV

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24
Q

which hepatitis virus does not have a carrier state?

2

A

HAV, HEV

A= absent carrier state

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25
Q

carrier states are common for which hepatitis viruses?

2

A

HBV, HCV

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26
Q

depends on HBV HBsAg coat for entry into hepatocytes

A

HDV

D= depends on

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27
Q
  • enteric
  • endemic to Asia, Africa, Middle east
A

HEV

E= enteric, endemic

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28
Q

lack an envelope and are not destroyed by the gut

A

HAV, HEV

vowels hit your bowels

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29
Q

can manifest in aplastic anemia

A

Hepatitis B

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30
Q

can manifest in membranous glomerulonephritis

A

HBV

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31
Q

can manifest in polyarteritis nodosa

A

HBV

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32
Q

can manifest in essential mixed cryoglobulinemia, increased risk of B cell NHL, ITP, and hemolytic anemia

A

HCV

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33
Q

can manifest in membranoproliferative glomerulonephritis

A

HCV

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34
Q

can manifest in leukocytoclastic vasculitis

A

HCV

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35
Q

can manifest in spontaneous cutanea tarda (porhyria), or lichen planus

A

HCV

36
Q

increases the risk of DM and autoimmune hypothyroidism

A

HCV

37
Q

which hepatitis viruses have a vaccine available?

A

A
B
E- in China

38
Q

what hepatic viruses manifest in chronic infection?

A

B
C
D- yes superinfection

39
Q

what hepatic viruses are spread fecal-orally?

A

A
E

40
Q

treatment for hepatitis A

A

supportive

41
Q

treatment for hepatitis E

A

supportive

42
Q

presents with nausea, vomiting, RUQ pain, increased bilirubin

acute or chronic

A

acute

43
Q

presents with fever, fatigue, weight loss, or may be asymptomatic

acute or chronic

A

chronic

44
Q

associated with a 100x increased risk of HCC

A

hep B

45
Q

best test to detect acute hepatitis A

A

Anti-HAV (IgM)

46
Q

indicates prior HAV infection and/or prior vaccination; protects against reinfection

A

Anti-HAV (IgG)

47
Q

antigen found on surface of HBV
indicates HBV infection

A

HBsAg

48
Q

indicates immunity to HBV due to vaccination or recovery from infection

A

anti-HBs

49
Q

antigen associated with core of HBV

A

HBcAg

50
Q

indicates acute/recent HBV infection

A

Anti-HBc (IgM)

51
Q

indicates prior or chronic HBV infection

A

anti-HBc (IgG)

52
Q
  • secreted by infected hepatocyte into circulation
  • indicates active viral replication, higher transmissibility and poorer prognosis
A

HBeAg

53
Q

antibody to HBeAg, indicates low transmissability

A

anti-HBe

54
Q

HBsAg +
HBeAg +
Anti-HBc IgM

A

acute HBV

55
Q

Anti-HBe +
anti-HBc IgM +

A

window

56
Q

HBsAg+
HBeAg +
Anti-HBc IgG +

A

chronic HBV with high infectivity

57
Q

HBsAg+
Anti-HBe +
Anti-HBc IgG

A

chronic HBV with low infectivity

58
Q

anti-HBs +
Anti-HBe +
Anti-HBc IgG

A

recovery

59
Q

anti-HBs +

A

immunized

60
Q

first line treatment for HBV

2

A
  • entecavir
  • tenofovir
61
Q

the ultimate goal of HBV treatment is to become […] negative

A

HBsAg

62
Q

why are immune modulators not preffered for HBV treatment

A

terrible flu-like side effects

63
Q

strongly discouraged treatment for HIV/HBV coinfection

A

lamivudine

64
Q

masks as a lipoprotein particle

A

Hep C

65
Q

treatment for HCV must include one from each of the following classes

A
  • NS3/4A inhibitors (-previr)
  • NS5A inhibitors (-asvir)
  • NS5B inhibitors (-buvir)
66
Q

coinfection vs superinfection

  • severe acute disease
  • low risk of chronic infection
A

coinfection

67
Q

coinfection vs superinfection

HBV and HDV at same time

A

coinfection

68
Q

coinfection vs superinfection

HDV after HBV

A

superinfection

69
Q

coinfection vs superinfection

  • usually develop chronic HDV infection
  • high risk of severe chronic liver disease
  • may present as acute hepatitis
A

superinfection

70
Q

treatment for HDV

A

pegylated interferon alpha

immune modulators

71
Q

in an acute HBV infection, […] appears concurrently with clearance of […] from the serum

A
  1. anti-HBsAg
  2. HBsAg
72
Q

[…] does not develop in patients chronically infected with HBV

A

anti-HBsAg

73
Q

what is the next best step for a person exposed to HAV?

A

go to local health department to receive IG

74
Q

a HBV/HDV coinfection or superinfection leads to a greater chance of developing

A

fulminant hepatitis

75
Q

HBcAg IgM +
HBsAg +
HBeAg+

A

acute hepatitis B

76
Q

HBcAg IgG +
HBsAg +
HBeAg +

A

chronic HBV infection

77
Q

HBcAg IgG +
HBsAg +

A

prior infection with development of chronic hepatitis

78
Q

anti-HBsAg +
HBeAg -
HBsAg -

A

vaccinated against HBV

79
Q

HAV IgM +

A

acute hepatitis A

80
Q

HAV IgG +

A

previous HAV infection or vaccination

81
Q

infection with […] results in lifelong immunity

A

HAV

82
Q

period in infection when neither HBsAg or anti-HBsAg is detectable in serum

A

window period

83
Q

[…] must be obtained to differentiate etiologies of viral hepatitis

A

serologies

84
Q

associated with development of HCC

A

HCV
HBV

85
Q

defective virus found only in people infected with HBV

A

HDV