B5-027 Hepatic Viruses Flashcards
1
Q
RNA picornavirus
A
HAV
2
Q
DNA hepadenavirus
A
HBV
3
Q
RNA flavivirus
A
HCV
4
Q
RNA deltavirus
A
HDV
5
Q
RNA hepevirus
A
HEV
6
Q
transmission route for HAV
A
fecal oral
shellfish, travelers, daycares
7
Q
transmission route HBV
A
parenteral (Blood)
sexual (bedroom)
perinatal (Birth)
3 Bs, HBV
8
Q
transmission route of HCV
A
blood
IV drug use, transfusion
9
Q
transmission route of HDV
A
parenteral
sexual
perinatal
10
Q
transmission route of HEV
A
fecal oral
waterbourne
11
Q
- is acute and self limiting in adults
- can be asymptomatic in children
A
HAV
A= acute, asymptomatic
12
Q
- intially presents like serum sickness (fever, arthralgias, rash)
- may progress to carcinoma
2
A
HBV, HDV
13
Q
may progress to cirrhoisis or carcinoma
A
HCV
C=cirrhosis, carcinoma
14
Q
fulminant hepatitis in pregnant patients
A
HEV
E=expectant mothers
15
Q
high mortality in pregnant patients
A
HEV
16
Q
pose of risk of progressing to HCC
3
A
HBV
HCV
HDV
17
Q
adults mostly experience full resolutions, but neonates have a far worse prognosis
A
HBV
18
Q
HDV after HBV is called
A
superinfection
poor prognosis
19
Q
HDV with HBV is called
A
coinfection
20
Q
biopsy shows
- hepatocyte swelling
- monocyte infiltration
- coucilman bodies
A
HAV
21
Q
biopsy shows
- granular eosinophilic “ground glass” appearance
- cytotoxic T cells
2
A
HBV, HDV
22
Q
biopsy shows
lymphoid aggregates with focal areas of macrovesicular steatosis
A
HCV
23
Q
biopsy shows
patchy necrosis
A
HEV
24
Q
which hepatitis virus does not have a carrier state?
2
A
HAV, HEV
A= absent carrier state
25
carrier states are common for which hepatitis viruses?
| 2
HBV, HCV
26
depends on HBV HBsAg coat for entry into hepatocytes
HDV
| D= depends on
27
* enteric
* endemic to Asia, Africa, Middle east
HEV
| E= enteric, endemic
28
lack an envelope and are not destroyed by the gut
HAV, HEV
| vowels hit your bowels
29
can manifest in aplastic anemia
Hepatitis B
30
can manifest in membranous glomerulonephritis
HBV
31
can manifest in polyarteritis nodosa
HBV
32
can manifest in essential mixed cryoglobulinemia, increased risk of B cell NHL, ITP, and hemolytic anemia
HCV
33
can manifest in membranoproliferative glomerulonephritis
HCV
34
can manifest in leukocytoclastic vasculitis
HCV
35
can manifest in spontaneous cutanea tarda (porhyria), or lichen planus
HCV
36
increases the risk of DM and autoimmune hypothyroidism
HCV
37
which hepatitis viruses have a vaccine available?
A
B
E- in China
38
what hepatic viruses manifest in chronic infection?
B
C
D- yes superinfection
39
what hepatic viruses are spread fecal-orally?
A
E
40
treatment for hepatitis A
supportive
41
treatment for hepatitis E
supportive
42
presents with nausea, vomiting, RUQ pain, increased bilirubin
| acute or chronic
acute
43
presents with fever, fatigue, weight loss, or may be asymptomatic
| acute or chronic
chronic
44
associated with a 100x increased risk of HCC
hep B
45
best test to detect acute hepatitis A
Anti-HAV (IgM)
46
indicates prior HAV infection and/or prior vaccination; protects against reinfection
Anti-HAV (IgG)
47
antigen found on surface of HBV
indicates HBV infection
HBsAg
48
indicates immunity to HBV due to vaccination or recovery from infection
anti-HBs
49
antigen associated with core of HBV
HBcAg
50
indicates acute/recent HBV infection
Anti-HBc (IgM)
51
indicates prior or chronic HBV infection
anti-HBc (IgG)
52
* secreted by infected hepatocyte into circulation
* indicates active viral replication, higher transmissibility and poorer prognosis
HBeAg
53
antibody to HBeAg, indicates low transmissability
anti-HBe
54
HBsAg +
HBeAg +
Anti-HBc IgM
acute HBV
55
Anti-HBe +
anti-HBc IgM +
window
56
HBsAg+
HBeAg +
Anti-HBc IgG +
chronic HBV with high infectivity
57
HBsAg+
Anti-HBe +
Anti-HBc IgG
chronic HBV with low infectivity
58
anti-HBs +
Anti-HBe +
Anti-HBc IgG
recovery
59
anti-HBs +
immunized
60
first line treatment for HBV
| 2
* entecavir
* tenofovir
61
the ultimate goal of HBV treatment is to become [...] negative
HBsAg
62
why are immune modulators not preffered for HBV treatment
terrible flu-like side effects
63
strongly discouraged treatment for HIV/HBV coinfection
lamivudine
64
masks as a lipoprotein particle
Hep C
65
treatment for HCV must include one from each of the following classes
* NS3/4A inhibitors (-previr)
* NS5A inhibitors (-asvir)
* NS5B inhibitors (-buvir)
66
# coinfection vs superinfection
* severe acute disease
* low risk of chronic infection
coinfection
67
# coinfection vs superinfection
HBV and HDV at same time
coinfection
68
# coinfection vs superinfection
HDV after HBV
superinfection
69
# coinfection vs superinfection
* usually develop chronic HDV infection
* high risk of severe chronic liver disease
* may present as acute hepatitis
superinfection
70
treatment for HDV
pegylated interferon alpha
| immune modulators
71
in an acute HBV infection, [...] appears concurrently with clearance of [...] from the serum
1. anti-HBsAg
1. HBsAg
72
[...] does not develop in patients chronically infected with HBV
anti-HBsAg
73
what is the next best step for a person exposed to HAV?
go to local health department to receive IG
74
a HBV/HDV coinfection or superinfection leads to a greater chance of developing
fulminant hepatitis
75
HBcAg IgM +
HBsAg +
HBeAg+
acute hepatitis B
76
HBcAg IgG +
HBsAg +
HBeAg +
chronic HBV infection
77
HBcAg IgG +
HBsAg +
prior infection with development of chronic hepatitis
78
anti-HBsAg +
HBeAg -
HBsAg -
vaccinated against HBV
79
HAV IgM +
acute hepatitis A
80
HAV IgG +
previous HAV infection or vaccination
81
infection with [...] results in lifelong immunity
HAV
82
period in infection when neither HBsAg or anti-HBsAg is detectable in serum
window period
83
[...] must be obtained to differentiate etiologies of viral hepatitis
serologies
84
associated with development of HCC
**HCV**
HBV
85
defective virus found only in people infected with HBV
HDV
