hep Flashcards

1
Q

whats the pathophysiology of hepatitis

A
  1. virus enters hepatocytes
  2. inflammatory and immune reactions lyse infected and neighboring cells
  3. direct antibody attack on viral antigens causes further destruction
  4. edema of interstitium leads to decrease blood flow, scarring, and fibrosis
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2
Q

define compensated cirrhosis

A

liver is scarred, but functions; no major complications

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3
Q

define decompensated cirrhosis

A

liver is heavily scarred and doesnt function properly;

development of major complications

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4
Q

what are 5 major coplications of decopensated cirrhosis

A
  1. ascites
  2. SBP
  3. variceal hemmorrhage
  4. hepatorenal syndrome
  5. hepatocellular carcinoma
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5
Q

how is + anti-HCV, + HCV RNA interpreted

A

have acute or chronic HCV depending on clinical context

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6
Q

how is + anti-HCV, - HCV RNA interpreted

A

resolution of HCV
OR
acute HCV during period of low-level viremia

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7
Q

how is - anti-HCV, + HCV RNA interpreted

A
early acute HCV
or
chronic HCV in setting of immunosuppressed state
or
false positive
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8
Q

how is - anti-HCV, - HCV RNA interpreted

A

absense of HCV infection

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9
Q

what is HBsAg?

A

hepatitis B surface antigen:

1st detectable serum antigen in acute infection; also present in chronic infections

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10
Q

what is anti-HBs

A

Hepatitis Surface antibody:
present after recovery from acute infection or after vaccination.
Confers protective immunity

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11
Q

what is anti-HBc

A

Total hepatitis B core antibody:
appears with onset of symptoms and persists for life
indicates previous or ongoing infection
not used to distinguish acute or chronic

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12
Q

what is IgM anti-HBc

A

IgM antibody to Hep B core antibody:

indicates acute infection

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13
Q

what is HBeAg

A

Hepatitiis B e antigen:

denotes ongoing active viral replication

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14
Q

what is anti-HBe

A

Hepatitiis B e antibody:

may indicate peak replication has passed

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15
Q

what is contained in a hep B virion envelope

A

hepatitis B surface antigen

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16
Q

what is contained in a hep B virion core

A

HBcAg/ HBeAg (nucleocapsid)
Double stranded circular DNA
DNA polymerase

17
Q

what are the two single antigen hep B vaccines

A

Recombivax HB

Engerix-B

18
Q

what are the 3 combo hep B vaccines

A

Combivax
Pediarix
Twinrix

19
Q

who should receive a combo hep B vaccine

A

people exposed to HBsAg + source by:

  1. acute blood exposure
  2. sexual exposure
  3. household exposure
  4. perinatal exposure
    - give w in 7 days
20
Q

what are 3 goals of HBV treatment

A
  1. increase chance of seroconversion
  2. prevent progression to cirrhosis and HCC
  3. minimize further injury in pts with ongoing liver damage
21
Q

seroconversion is the change of _______ to _______

A

HBeAg to anti-HBe