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Gastrointestinal > Viral Hepatitis II > Flashcards

Viral Hepatitis II Flashcards

1
Q

What is the family of Hep C? Genetic content? Enveloped?

A

Flaviviridae
+ssRNA
Enveloped

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2
Q

What country has the highest incidence of Hep C?

A

Egypt

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3
Q

How fast does Hep C mutate?

A

Few Years

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4
Q

What disease is very closely associated with Hep C?

A

HIV

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5
Q

What populations have high rates of Hep C (beside those with HIV)?

A

IV drug users

Inmates

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6
Q

How does Hep C transmit in cocain?

A

Blood on straws and nosebleeds

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7
Q

The highest prevalence of Hep C is in what population?

A

AA males born before 1964

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8
Q

What is the average cost of a liver transplant for HCV?

A

$430,000/first year

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9
Q

What is the chance of getting HCV from a blood transfusions?

A

1/10^7

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10
Q

Why are clotting factors more susceptible to HCV? Getting clotting factors before what year should be suspicious for Hep C infection?

A

Clotting factors are pooled from multiple patients

1987

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11
Q

Blood transfusion or organ transplant before what year have a 5-10% risk for getting Hep C?

A

1992

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12
Q

What is the chance of getting Hep C from a needle stick? HIV?

A

HIV = 1/20

Hep C = 1/3

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13
Q

What is the overwhelming cause of getting Hep C?

A

Injection drug use

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14
Q

What happens to ALT levels in Hep C infections? Which other Hep virus does this?

A

Oscillation between normal and abnormal

No other Hep virus does this

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15
Q

True or false: despite having normal LFTs, Hep C patients can develop cirrhosis

A

True

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16
Q

What percent of Hep C patients will die from live cancer each year?

A

4%

17
Q

What are the four factors that are associated with fibrosis in Hep C infection?

A

Duration of infection
EtOH use >50g/day
Age >40
Male gender

18
Q

What are the ssx of acute infection with Hep C? Chronic? Advanced?

A

Acute- asymptomatic to jaundiced
Chronic = Fatigue, depression
Advanced = ssx of live rfailure

19
Q

What are the three major complications of cirrhosis caused by Hep C?

A

Hepatic encephalopathy
Portal HTN
Hepatorenal syndrome

20
Q

What are the vascular association with HCV?

A

Necrotizing vasculitis

Polyarteritis nodosa

21
Q

What happens with coinfection of Hep C and HIV?

A

Faster destruction of the liver

22
Q

What age group should be screened for hep C?

A

Baby boomers (1940–1964)

23
Q

Why is it hard to determine if a pt has Hep C?

A

LFTs can be completely normal

24
Q

What are the diagnostic tests for HCV?

A

HCV antibody
Genotyping
Liver biopsy

25
Q

What genotype is the most common HCV? What is the hardest to treat?

A

Type I most common

26
Q

What is the single most important prognostic factor for HCV infection?

A

Genotype

27
Q

What is the primary goal of HCV infection?

A

Eradicate HCV infection

28
Q

What is a sustained viral response? Is this a cure? How does this occur?

A

Sustained effect of drug against the virus. Prevents the replication of the virus.

This is not a cure.

29
Q

What is pegylation? How is this effective?

A

Add a huge, inert chain of amino acids to the medication that you want.

This increases the time for clearance, meaning lower doses can be used.

30
Q

What are the side effects of interferon?

A

ILI
Myalgia/arthralgia
Myelosuppression
N/v, weight loss

31
Q

What are the two medications that appeared in 2011 that can treat HCV? Are these still used?

A

DAA (direct antiviral agents)

Telaprevir and Boceprevir

no longer used

32
Q

What is the MOA of Telaprevir and Boceprevir?

A

Protease inhibitors

33
Q

What is the MOA of Sofosbuvir + Ledipasvir? (3)

A
  1. Block viral protease
  2. Block RNA pol
  3. Block Capping mechanism
34
Q

What is the treatment for HCV?

A

Sofosbuvir + Ledipasvir

35
Q

What are the side effects of Sofosbuvir + Ledipasvir?

A

Nausea

36
Q

What is the cure rate with Sofosbuvir + Ledipasvir?

A

95-99%

37
Q

HCV accounts for what percent of hepatomas in the US?

A

1/3

Gastrointestinal (42 decks)

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