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GI/Liver > Lec 19 Hepatitis ABCs > Flashcards

Lec 19 Hepatitis ABCs Flashcards

1
Q

What types of hepatitis can become chronic?

A

Hep B, C, D

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2
Q

How do you diagnose viral hepatitis?

A

by serology –> liver biopsy does not distinguish between them

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3
Q

What signs/symptoms of viral hepatitis?

A
  • fever
  • jaundice
  • high ALT/AST
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4
Q

How do you diagnose Hep A?

A

IgM anti-HAV during acute phase

usually positive w/in 2 weeks of symptom presentation

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5
Q

What is morphology of Hep A? [DNA/RNA, stranded]?

A

single stranded RNA

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6
Q

What family of virus if hep A?

A

picornavirus

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7
Q

What does IgG anti-HAV tell you?

A

tells you the patient previously had Hep A

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8
Q

How is hep A transmitted?

A

fecal-oral

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9
Q

How does hep A present?

A

mostly asymptomatic in adults; affects children more

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10
Q

What is treatment for Hep A?

A

usually self-limited

supportive treatment

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11
Q

What is prophyxlaxis for hep A?

A

inactivated/killed virus vaccine

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12
Q

What are 3 potential complications of Hep A?

A
  • cholestatic hepatitis
  • fulminant hepatic failure
  • relapsing Hep A
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13
Q

Which hepatitis is most common cause of acute and chronic liver disease and hepatocellular carcinoma?

A

Hep B

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14
Q

What is morphology of Hep B [DNA/RNA, stranded]?

A

double stranded DNA virus

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15
Q

What is hepatitis E antigen?

A

marker of HBV replication and infectivity = envelope antigen

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16
Q

How long does it take from start of infection to symptom onset in HBV?

A

60-90 days

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17
Q

What does HBV DNA tell you?

A

quantitiative marker of replication

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18
Q

What does HBeAg tell you?

A

marker of Hep B viral replication and infectivity

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19
Q

What does HBsAg tell you? When is it detectable?

A

first detectable marker upon acute infection

precedes rise in AST/ALT and symptoms

undetectable 1-2 months after onset of jaundice

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20
Q

What does positive anti-HBs antibody tell you?

A
  • received HBV vaccination OR cleared acute HBV infection
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21
Q

Which HBV markers are positive in acute HBV of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?

A
  • HBsAg
  • HBeAg
  • anti-HBc IgM
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22
Q

Which HBV markers are positive in window period of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?

A
  • anti-HBe

- anti-HBC IgM

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23
Q

Which HBV markers are positive in chronic inactive HBV of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?

A
  • HBsAg
  • anti-HBe
  • anti-HBC IgG
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24
Q

Which HBV markers are positive after recovery of HBV of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?

A
  • anti-HBs
  • anti-HBe
  • anti-HBC IgG
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25
Q

Which HBV markers are positive in an immunized patient of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?

A

anti-HBs only

26
Q

Which HBV markers are positive in chronic active HBV of the following: HBsAg, anti-HBs, HBeAg, anti-HBe, anti-HBs, anti-HBC-IgM, anti-HBC-IgG?

A
  • HBsAg
  • HBeAg
  • anti-HBC IgG
27
Q

What defines chronic HBV?

A

persistent HBsAg

28
Q

Is ALT or AST generally greater in viral hepatitis?

A

ALT > AST in viral hepatitis

29
Q

What are escape mutants?

A

people who have loss of anti-HBs neutralizing activity

have possibility of acquiring infection despite having anti-HBs from vaccination

30
Q

How is Hep B transmitted?

A
  • perenteral –> blood transfusion, needle stick, IV drug use
  • sexual
  • maternal-fetal
31
Q

What is the most common cause of chronic viral hepatitis in Asia and Africa?

A

Hepatitis B

32
Q

How is HBV usually acquired in childhood? Symptomatic or subclinical in acute stage?

A

acquired perinatally or in preschool

infection = subclinical

33
Q

How is HBV usually acquired in adulthood? Symptomatic or subclinical in acute stage?

A

acquired by sexual contact, injection drug use, or exposure to blood

infection = symptomatic

34
Q

From Hep B how many people go on to get chronic infection? neonates vs adults?

A

neonates –> 90% become chronic

adults –> 90% clear the virus

35
Q

How do you get HCC without cirrhosis in hep B?

A

HBV integrates into the host genome and can act as an oncogene

36
Q

What tumor marker is commonly elevated in pts wtih HCC?

A

alpha fetoprotein

37
Q

What is incubation period for Hep C?

A

1-2 months

38
Q

What is most sensitive indicator of Hep C infection?

A

HCV RNA

39
Q

WHat is most common genotype of hep C in the US?

A

genotype 1

40
Q

What family of viruses does HBV belong to?

A

DNA hepadnavirus

41
Q

What family of viruses does HCV belong to?

A

RNA flavivirus

42
Q

What is the morphology of HCV [DNA/RNA, strandedness]?

A

positive strand RNA

43
Q

Are HCV infections usually asymptomatic or symptomatic?

A

usually asymptomatic

44
Q

What is the most common cause of chronic viral hepatitis in USA and europe?

A

Hep C

45
Q

How is Hep C transmitted?

A

primarily blood, sexual transmission, perinatal, injection drug use

46
Q

What percentage of people with hep C go on to chronic disease?

A

50-70%

47
Q

What is the best indicator of HCV treatment response?

A

sustained viral response at > 6 months after end of treatment

48
Q

What is treatment for HCV [3 drugs together]?

A

combo protease inhibitor + pegylated interferon + ribavirin

49
Q

When do you begin to detect HCV antibody?

A

detected at 1-3 months after acute infection

50
Q

What is morphology of hepatitis D [DNA/RNA, stranded]?

A

single stranded RNA virus

51
Q

What family of virus is hep D?

A

delta virus

52
Q

Who gets hep D?

A

only in people that are infected with HBV –> required HBV for replication and expression

53
Q

What is hep D superinfection?

A

acute hep D in presence of chronic Hep B

54
Q

How do you diagnose hep D?

A

IgM anti-HDV

55
Q

How is Hep D transmitted?

A

parenteral, sexual

56
Q

Where is hep D endemic?

A

mediterranean, middle east, south america, africa

57
Q

What is treatment for Hep D?

A

interferon

58
Q

What is incubation period for hep E?

A

short = 1 month

59
Q

How is hep E transmitted?

A

fecal oral

60
Q

How do you diagnose Hep E virus?

A

anti-HEV IgM

61
Q

Who is at risk for serious complications with hep E?

A

pregnant women –> can lead to fulminant hepatitis and death

GI/Liver (36 decks)

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