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Infectious Disease > Hepatitis Virus > Flashcards

Hepatitis Virus Flashcards

1
Q
  • picornavirus, aka enterovirus 72
  • small nonenveloped
  • replicates exclusively in cytoplasm
A

hepatitis A

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2
Q
  • infectious naked viral RNA

- synthesis of polyprotein, one of proteins synthesized is RNA dependent RNA polymerase

A

hepatitis A

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3
Q
  • discrete onset of symptoms (nausea, anorexia, fever, malaise, abdominal pain)
  • jaundice or elevated AST/ALT
  • confirm with positive IgM antibody
A

acute hepatitis A

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4
Q

incubation period of hepatitis A?
complications?
chronic seqeualae?

A

average 30 days
fulminant, cholestatic, relapsing hepatitis
no chronic

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5
Q

hepatitis A transmission?

A

close personal contact, contaminated food and water, blood exposure

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6
Q

hepatitis A vaccine is ________ adsorbed onto aluminum hydroxide, given to persons ______ and older, has two doses

A

inactivated

12 months and older

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7
Q
  • ssRNA genome, hepeviridae
  • seven genotype, 4 cause human disease
  • generally transmitted fecal oral
A

hepatitis E

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8
Q

incubation of hepatitis E?
highest fatality group with hepatitis E?
illness severity?
chronic sequelae?

A

40 days
pregnant women, 15-25% fatality
increased with age
none

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9
Q
  • flavivirus, enveloped (+)ssRNA

- replication confined to cytoplasm

A

hepatitis C

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10
Q

HCV virus genome?

A

E1 and E2 envelope proteins, capsid protein

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11
Q

transmission of HCV?

A
  • percutaneous: IV drug use, transfusion, needlestick

- permucosal: perinatal, sexual (low incidence)

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12
Q 
incubation of hep C?
acute illness (jaundice)?
chronic infection?
chronic hepatitis?
cirrhosis?
A 
6-7 weeks 
mild
75-85%
70-85%, most symptomatic
10-20%
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13
Q

factors promoting severity of hep C?

A

alcohol, age >40 years at time of infection, HIV coinfection, male gender, chronic HBV infection

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14
Q

in hepatitis B

  • envelope protein known as _____
  • nucleocapsid protein known as _____
  • _______ necessary for replication of viral genome
  • early antigen known as ______
  • _______ linked to hepatocellular carcinoma
A
  • surface antigen (HBsAg)
  • core antigen (HBcAg)
  • reverse transcriptase
  • HBeAg
  • X protein
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15
Q

hepatitis B virion and particles?

A

virion (Dane particle)
secreted filaments
spherical particles

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16
Q

________ is not incorporated into virions and is secreted from the cell

A

HBeAg

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17
Q

secreted from the cell and observed in plasma at early times post infection, altered antigenic structure due to disulfide bond, development of antibodies correlates with reduction in HBV viremia

A

HBeAg

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18
Q

hepatitis B incubation period?
jaundice?
chronic infection?
premature mortality from chronic liver disease?

A

60-90 days
more likely if older than 5
more likely if under 5
15-25%

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19
Q

transmission of hepatitis B? highest concentration in body fluids?

A

sexual, parenteral, perinatal

blood, serum, wound exudates

20
Q

marker of infectivity of hepatitis B?

A

HBsAg surface antigen

21
Q

marker of immunity when found in serum for hep B?

marker of past or current infection?

A

anti-HBsAg

anti-HBcAg

22
Q

IgM anti-HBc indicates _______ infection with HBV

A

recent (4-6mo)

23
Q

IgG anti-HBc indicates _______ infection with HBV

A

old

24
Q

indicates active HBV infection, can only be present if HBsAg is positve

A

HBeAg

25
Q

HBsAg negative
anti-HBc negative
anti-HBs negative

A

susceptible to HBV infection

26
Q

HBsAg negative
anti-HBc positive
anti-HBs positive

A

immune due to natural infection

27
Q

HBsAg negative
anti-HBc negative
anti-HBs positive

A

immune due to vaccine

28
Q

HBsAg positive
anti-HBc positive
IgM anti-HBc positive
anti-HBs negative

A

acutely infected

29
Q

HBsAg positive
anti-HBc positive
IgM anti-HBc negative
anti-HBs negative

A

chronically infected

30
Q

HBsAg negative
IgM anti-HBc positive
anti-HBs negative

A

4 interpretations:

  • resolved HBV infection
  • susceptible w/ false positive anti-HBc
  • low level chronic infection
  • resolving an acute infection
31
Q

in asymptomatic carrier HBV, liver is normal except scattered hepatocytes with _________, containing HBV particles, filamentous and spherical forms

A

ground glass cytoplasm

32
Q

in chronic persistent hepatitis, viral hepatitis leads to liver cell destruction, inflammation confined to ______

A

portal tracts

33
Q

in chronic active hepatitis, a ___________ inflammatory infiltrate extends from portal areas, leading to _______ and hallmark apoptotic bodies called ________

A

mononuclear
piecemeal necrosis
councilman bodies

34
Q

in HCV, influx of cytotoxic T cells into liver doesn’t occur for _____, (other viruses 1 week), implicated in the pathogenesis of viral hepatitis

A

2-3 months

35
Q

patients with weak CTL responses generally have ________

A

less liver damage

36
Q

small ssRNA, circular genome, codes for one protein and one mRNA

A

hepatitis D

37
Q

hepatitis D is a ______ virus, which requires coinfection with HBV that provides ______

A

defective

HBsAg

38
Q

replication of the hep D genome occurs in the ______, and acquires HBsAg at the _______

A

nucleus

golgi complex

39
Q

hepatitis D modes of transmission?

A

percutaneous (IV drug use), permucosal sexual contact

40
Q
  • severe acute disease and higher incidence of fulminant hepatits than HBV alone
  • low risk of chronic infection
A

HDV Co-infection

41
Q
  • usually develop chronic HDV infection
  • high risk of severe chronic liver disease (70-80%)
  • higher risk of fulminant hepatitis than HBV alone
A

HDV superinfection

42
Q

hepatitis B vaccine is based on the concept that antibodies to _______ of HBV are protective, given as series of 3 ______ doses

A

surface glycoproteins

intramuscular

43
Q

treatment options for chronic hep B?

A
  • pegylated interferon alpha-2a
  • 3TC lamivudine
  • adefovir dipivoxil
  • entecavir
  • telbivudine
  • tenofovir
44
Q

HBV and HCV are linked to 70-80% of cases of what cancer?

A

hepatocellular carcinoma

45
Q

major predisposing factor for HBV and HCV induced HCC is development of?

A

cirrhosis

46
Q

role of HBV and HCV in carcinogenesis?

A
  • chromosome instability –> loss of tumor suppressor genes
  • insertional mutagenesis: disruption of cell cycle control genes
  • hep b protein X: transactivates host genes, blocks tumor suppressors, interacts with mitogenic paths

Infectious Disease (22 decks)

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