Hepatitis A, B, D, E

Question 1

what are the signs and symptoms of hepatitis?

Answer 1

most patients have no symptoms, or have vague symptoms

when there are symptoms, they are usually flu like

Question 2

what are the hereditary causes of hepatitis?

Answer 2

wilsons
hemochromatosis
a1AT deficiency

Question 3

what are the self limiting hepatitises?

Answer 3

A and E

Question 4

what are the clinical features of autoimmune hepatitis?

Answer 4

female 
increased ALT/AST 
ANA positive 
ASMA positive 
anti-LKM 
portal triaditis

Question 5

which antibody is positive in primary biliary cirrhosis?

Answer 5

AMA

Question 6

PBC carries a high risk for what disorder?

Answer 6

osteoporosis

Question 7

which biliary disease is associated with UC?

Answer 7

PSC

Question 8

which biliary disease is associated with an ANCA positive test?

Answer 8

PSC

Question 9

what are the causes of self limited viral hepatitis?

Answer 9

CMV 
herpes 
EBC 
yellow fever 
adenovirus 
HIV

Question 10

where does HAV replication take place?

Answer 10

cytoplasm of hepatocyte

Question 11

what are the routes of transmission for HAV?

Answer 11

fecal-oral (most common)
close personal contact
blood borne (rare)

Question 12

what is the only DNA hepatitis virus?

Answer 12

B

Question 13

what is the mechanism of HBV infection?

Answer 13

integration into genome

Question 14

what are the routes of transmission for HBV?

Answer 14

permucosal (most common)

percutaneous

Question 15

what is the most common and most significant mechanism of HBV transmission?

Answer 15

birth

Question 16

if a baby becomes infected with HBV at birth, what is the chance of it becoming chronic?

Answer 16

90%

Question 17

when do you start treating HBV infection?

Answer 17

starting at 6 months when it becomes chronic (otherwise observe)

Question 18

if patients are surface antigen positive, what does that mean?

Answer 18

active infection

Question 19

patients with only surface antibody to HBV means what?

Answer 19

have never been exposed to complete virus - confirms response to vaccination

Question 20

what is the good news about inactive carrier state in HBV infection?

Answer 20

no inflammation

Question 21

what are the therapeutic agents for HBV?

Answer 21

interferon

lamivudine

Question 22

which HBV therapeutic is an immune modulator analog?

Answer 22

interferon

Question 23

what is the only treatment that can completely wipe out HBV in the body?

Answer 23

interferon

Question 24

which HBV therapeutic is a nucleo(s)tide?

Answer 24

lamivudine

Question 25

interferon is what type of HBV agent?

Answer 25

immune modulator analog

Question 26

lamivudine is what type of HBV agent?

Answer 26

nucleo(s)tide

Question 27

which agent can be used in HBV patients who are refractory to lamivudine?

Answer 27

adefovir

Question 28

why is lamivudine still used, despite resistance risk?

Answer 28

only HBV drug that is safe for pregnant women

Question 29

which hepatitis virus causes fulminant hepatic failure if infection occurs in pregnant women?

Answer 29

E

Question 30

what is the unique feature of HEV?

Answer 30

behaves like A except when infection occurs in a pregnant woman

Question 31

what is responsible for hepatitis E infection in the US?

Answer 31

zoonotic infections from swine reservoirs (Midwest)