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Gastrointes 2 > 011315 viral hepatitis > Flashcards

011315 viral hepatitis Flashcards

1
Q

clinical manifestations of acute viral hepatitis

A

fever, malaise, anorexia, nausea, vomiting, jaundice, abdominal/RUQ pain, hepatomegaly

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2
Q

is there inflammation in chronic hepatitis?

A

no (only in acute)

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3
Q

what is the one test for diagnosing hep A?

A

Hep A antibody

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4
Q

what does Hep A IgG suggest?

A

previous exposure (more than 6 months out) and now immune or vaccination

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5
Q

does getting hepatitis A provide you with a protective antibody?

A

yes, the IgG is protective

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6
Q

is hep A acute or chronic?

A

acute (can kill you in couple wks)

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7
Q

how do you prevent hep A

A

hygiene (hand washing)
sanitation (clean water sources)

immune globulin (pre and post exposure)
hep A vaccine (pre exposure)
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8
Q

how is hep A transmitted?

A

fecal oral

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9
Q

uses of hep A immunoglobulin

A

pre-exposure:
travelers to HAV-endemic areas

post-exposure (within 2 wks)

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10
Q

how to diagnose hep E?

A

hep E Ab (hep E IgM represents acute, hep E IgG represents previous exposure and now immune)

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11
Q

does hep IgG protect against future infection?

A

yes

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12
Q

tx for acute hep E

A

supportive

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13
Q

presence of HBeAg represents

A

lot of virus in bloodstream

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14
Q

presence of anti-HBe represents

A

seroconversion-means you have cleared virus from the bloodstream

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15
Q

seroconversion for hep B occurs in whom?

A

adults

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16
Q

presence of HBsAg suggests

A

you have Hep B disease (4-24 wks after exposure for an adult, will be positive)

17
Q

presence of anti HBc Ig

A

IgM is postive during acute phase

IgG is positive in chronic

18
Q

anti HBs

A

means you are immune to Hep B

19
Q

in chronic hep B, what is different from acute hep B?

A

the HBsAg doesn’t go away

the HBeAg doesn’t go away

20
Q

how can you diagnose hep B

A

hep B surface antigen + means current hep B (acute or chronic)

hep B surface ab positive means immunity (recovered from natural infec or vaccine)

IMPORTANT test is core antibody, which represents natural exposure

21
Q

transmission of hep B occurs how?

A

high risk-blood, serum, wound exudates

moderate-semen, vaginal fluid, saliva

22
Q

risk factors for hep B

A 
heterosexual sex
MSM
IV drug users
household contacts of HbsAg + ppl
travelers to endemic areas
people occupationally exposed
chronic renal failure pts
23
Q

what to do for unvaccinated pt who’s contracted hep B

A

give hep B Ig within one week
or
hep B vaccine within one week

24
Q

in hep B surface antigen + mothers, what do you give newborn?

A

both HBIG and vaccine

25
Q

chronic hep B-goal of therapy

A

eliminate or significnatly suppress HBV replication
prevent progression to cirrhosis and possibly HCC
ALT normalization
histological improvement (reduce inflam)
loss of HBeAg, development of HBeAb
loss of HBsAg

26
Q

how to tx chronic hep B

A

IFN (interferon) to activate immune system

nucleotide/nucleoside analogues to block reverse transcriptase which is necessary for HBV replication

27
Q

nucleotide analogs are used for chronic hep B in the attempt to do what?

A

try to make seroconversion happen (use entacavir and tenofovir only b/c these are the ones that viruses are not resistant to)

28
Q

Peg-IFN is used for

A

Hep B–if low viral load and high ALT/AST

29
Q

why is therapy for hep B important?

A

prevents progression to cirrhosis and possibly HCC

30
Q

what happens in HBV/HDV coinfection?

A

HDV RNA and HBsAg are seen transiently

eventually, anti-HDV IgG goes away

31
Q

what happens in HBV/HDV superinfection

A

ALT fluctuates with HDV RNA present
HDV RNA and HBsAg are seen
anti HDV IgG persists

32
Q

how to diagnose hep D?

A

hep D IgM means acute infec

hep D IgG means previous exposure

33
Q

is hep D IgG protective?

A

no

34
Q

how to diagnose hep C

A

hep C antibody seen in all exposures and remains present in all pts including those who spontaenously clear virus or undergo successful tx

hep C viral RNA is there only in viremic pts

Gastrointes 2 (15 decks)

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