Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Case 6 > Case 6 - Global Perspectives of Viral Liver Disease > Flashcards

Case 6 - Global Perspectives of Viral Liver Disease Flashcards

(64 cards)

Start Studying
1
Q

what’s the difference b/w liver cirrhosis and liver fibrosis?

A

the main difference between them is cirrhosis is a severe stage of fibrosis and is irreversible, but fibrosis is reversible and if given time to heal it can heal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hep B core antigen is part of?

A

part of nucleocapsid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

name the different types of hepatitis

A
  • Hepatitis A (HAV)
    RNA virus
    Food & water borne, (sexual)
  • Hepatitis B (HBV)
    DNA virus
    Blood & body fluids
  • Hepatitis C (HCV)
    RNA virus
    Blood & body fluids
  • Hepatitis D (delta)
    RNA viroid
    Only found in association with HBV
  • Hepatitis E (HEV)
    RNA virus
    Food & waterborne
  • Others eg Cytomegalovirus, Epstein-Barr virus, Adenovirus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the [3] viruses associated with
* Acute hepatitis
* Should be considered in
adolescents or young
adults with acute
hepatitis

A

Cytomegalovirus, Epstein-Barr virus, Adenovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

transmission of HAV and is it acute or chronic or both?

A

faecal/oral transmission
it’s acute, not chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

transmission of HBV and is it acute or chronic or both?

A

Blood-borne transmission
can be acute and chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

transmission of HCV and is it acute or chronic or both?

A

blood borne transmission
can be acute and chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

transmission of HEV and is it acute or chronic or both?

A

faecal or oral transmission
yes it’s acute and not generally chronic, but can be chronic in elderly and immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

acute hepatitis

A
  • Spontaneous viral clearance by the immune system
  • Usually within weeks or months
  • Hep A, Hep E, Hep B (unless acquired in infancy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

chronic hepatitis

A
  • The immune system fails to clear the virus
  • Viral persistence for > 6 months
  • Usually long-term (unless treated)
  • Hep B, Hep C (80% of cases)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the significance of the Lipid envelope?

A

Enveloped viruses, such as HBV, HCV, HDV - virion particles are released from a cell; the virion particles cause minimal damage to a cell; envelope carries certain antigens which is important, some of the antigens important for immune invasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which hepatitis have lipid envelope?

A

HBV
HCV
HDV - it borrows an envelope from HBV, specifically the HBsAg (Hepatitis B surface antigen).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how does HEV differ from HAV?

A

Hep A – only humans are the natural host
Hep E – can have humans and pigs being infected (can have an additional zoonotic mode of transmission)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

HAV and HEV are what kind of viruses?

A

HAV and HEV are non-enveloped
viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

HAV and HEV are stable in environment for how long?

A

Stable in the environment for
weeks or months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

transmission of HAV and HEV

A

Oral–faecal transmission (Enteric
transmission)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

The hosts HAV and HEV is _____ before the onset of symptoms

A

infectious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

most common source of HAV is?

A

direct person-to person exposure
Mainly foodborne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

most common source of HEV is?

A
  • Seen in countries of of low socioeconomic status
    and poor sanitation.
  • Mainly waterborne (rain season)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Infections with Hepatitis A & E viruses can be ________ , especially in children.
With HEV, severe infections can occur in pregnancy (esp. third trimester) with a mortality rate approaching 25%.

A

asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

symptoms of Hep A and Hep E

A

▪ Fever, malaise
▪ Nausea & vomiting
▪ Jaundice & dark urine
▪ Diarrhoea
▪ RUQ pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

signs of Hep A and Hep E

A

▪ Jaundice
▪ Tender & enlarged liver (hepatomegaly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hepatitis A: Risk Groups

A

developed, poorer countries - e.g africa, south asia, south america
* International travellers to regions with poor sanitation and where HAV is endemic
* Persons with clotting factor disorders (rare)
* MSM (rare)
* Users of illegal drugs (rare)
* Persons in institutions (rare)
* Schools (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hepatitis E: Risk Groups

A

common in central and south america, middle east and far east Asia
* International travellers to regions with poor sanitation and where HEV is
endemic
* Men older than 60 years of age
* Farmers
* Animal butchers
* Veterinarians
* Handlers of animal products
* Immune-suppressed patients (HIV infected, post-transplant, recipients of
chemotherapy)
common in displaced people and refugee camps - bc it’s hard to access clean water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Serological diagnosis for HAV
Detection of specific antibodies: * Anti-HAV IgM Indicates recent infection * Anti-HAV IgG Indicates past infection or immunisation
26
incubation period of HAV is?
2-6 weeks
27
incubation period of HEV is?
2-6 weeks
28
Serological diagnosis of HEV?
Detection of specific antibodies: * Anti-HAV IgM Indicates recent infection * Anti-HAV IgG Indicates past infection or immunisation
29
Hepatitis A: Preventive Measures
* Prevent transmission of HAV within households and close contacts, hand washing and food hygiene * Boil contaminated water for 20 minutes or expose the virus to chlorine, formalin or UV light * Vaccination
30
Hepatitis A: Vaccination
Active immunisation Passive immunisation
31
what is Passive immunisation of Hep A
Human normal immunoglobulin (HNIG) from individuals with high titer anti-HAV IgG can be used for post-exposure protection of contacts (together with active vaccine)
32
what is active immunisation of Hep A
* Prepared from inactivated, whole Hepatitis A virus * Single dose by IM (intramuscular) injection * Booster dose at 6 months gives lifelong immunity * Live, attenuated vaccine available but rarely used
33
Hepatitis A: Prophylactic Vaccination
HAV Vaccination - recommended for: * Travellers to endemic areas * Patients with chronic liver disease * MSM, HIV infected individuals * Sewage workers * Staff in residential institutions
34
Hepatitis E: Prevention & Vaccination
* Avoid untreated water * Cook food (especially pork) appropriately * Maintain good personal hygiene * No licensed vaccine (but one in development)
35
Hepatitis C (& D): Routes of Transmission
Vertical - [mother to baby through infected maternal blood or genital tract secretions and also termed perinatal transmission or horizontal via infected family member to infant] Sexual (via seminal fluid and genital tract secretions) Blood transfusion - it's rare and can occur in haemophiliacs IV drug use/needle sharing (includes tattooing, acupuncture, body piercing) and razors - high risk Healthcare workers e.g needlestick injuries Nosocomial - Contaminated needles and syringes, medical (blood glucose monitoring), surgical and dental procedures
36
__1__risk if mother chronically infected and positive for HBsAg and HBeAg ___2___ risk if mother is chronically infected and only positive for HBsAg
1 - 70 - 90%/high 2 - 10%/low
37
Hepatitis B (& D): Risk Groups
* Children born to mothers chronically infected with HBV * Individuals frequently requiring blood or blood products, dialysis patients, and recipients of solid organ transplantation * Prisoners * Individuals who inject drugs * Household and sexual contacts of patients with chronic HBV infection * Individuals with multiple sexual partners * Healthcare workers who may be exposed to blood and blood products * Travellers to regions where HBV is endemic
38
Hepatitis C is usually ___1___ during the acute stage. Most patients develop __2__ infection with HCV.Effective treatment is available for HCV.
1 - asymptomatic 2 - chronic
39
why is HCV a silent killer?
3 out of 4 of baby boomers will have Hep C and more than 50% of them won’t know they have it. and they die from it
40
Hepatitis C: Routes of Transmission
IV drug use/sharing of injection equipment Blood transfusion * Very rare * Haemophiliacs Sexual * Rare Vertical (mother to child) * <3% Healthcare workers * Needlestick injuries Nosocomial * Reuse or inadequate sterilisation of medical equipment
41
where is the highest rate of HCV infection in the world
Egypt [80% of Hepatocellular Carcinoma cases occur in low income countries]
42
Hepatitis C: Risk Groups
* Children born to mothers chronically infected with HCV * Individuals frequently requiring blood or blood products, dialysis patients, and recipients of solid organ transplantation * Prisoners * Individuals who inject drugs * Individuals who use intranasal drugs * Household and sexual contacts of patients with chronic HCV infection * Individuals who have had tattoos or piercings * Healthcare workers who may be exposed to blood and blood products
43
Complications of Viral Hepatitis
Liver fibrosis/cirrhosis * Variable progression over the years End-stage liver disease * Portal hypertension/ascites * Bleeding oesophageal varices * Liver failure Hepatocellular Carcinoma (HCC)
44
HBV: Detection of _______ in serum indicates infection
viral surface antigen (HBsAg)
45
______ IgM indicates acute infection
Anti-HBcAg = anti hepatitis B core antigen
46
Acute HBV: Surface antibody (anti-HBsAg IgG) indicates what?
* Indicates viral clearance * Post vaccination
47
Incubation period of HBV
6 weeks to 6 months
48
what are the Hep B antigens?
HBsAg - hepatitis B surface antigen HBeAg - hepatitis B e antigen HBcAg - hepatitis B core antigen
49
HBsAg - hepatitis B surface antigen this indicates what?
indicates HBV infection - can be acute or chronic
50
Anti-HBcAg IgM indicates what?
acute infection of HBV
51
If HBeAg (hepatitis B e antigen) is positive, this indicates?
High levels of viral replication The patient is highly infectious
52
Risk of developing chronic infection of HBV depends on?
depends on age at the time of infection * <5% in adults * 90% in neonates/infants
53
what do you have in Hepatitis B: Acute infection?
Detection of viral surface antigen (HBsAg) in serum indicates infection * Acute or chronic Anti-HBcAg IgM indicates acute infection Surface antibody (anti-HBsAg IgG) * Indicates viral clearance * Post vaccination
54
what do you have in Hepatitis B: chronic infection?
Persistent HBsAg (Hepatitis B surface antigen) Presence of HBeAg (Hepatitis B e antigen), part of viral core * High infectivity * High risk of liver damage * Viral DNA detectable in plasma (PCR)
55
Hepatitis C Screening & Diagnosis
2 steps: * IgG antibodies against HCV * Detect HCV RNA
56
Prevention of Hepatitis B infection
* Screen /viral inactivation of blood products for transfusion * Safe sex * Avoid needle/syringe sharing * Hepatitis B vaccine
57
Hepatitis B vaccine recommended for:
* Offspring of mothers chronically infected with HBV * Healthcare workers * Injecting drug users * MSM, HIV infected individuals * Chronic liver disease, chronic kidney disease * Travellers to high prevalence areas * Post-exposure * Prisoners and prison staff
58
Hepatitis B Vaccination includes two types which are:
Active Immunisation Passive Immunisation
59
Active Immunisation of HBV
HBsAg prepared in yeast cells by recombinant DNA technology * Sub-unit vaccine 3 doses by IM injection Response to the vaccine can be checked by measuring the level of anti-HBs IgG antibody (>100 IU/ml protective)
60
passive Immunisation of HBV
* Specific Hepatitis B immunoglobulin (HBIG) can be used for post-exposure protection of contacts (together with active vaccine) * Prepared from plasma of immunised donors who have high titers of anti-HBsAg IgG
61
Prevention of Mother-to-Child Transmission of HBV
Babies born to mothers with chronic HBV Vaccination of infant * 3 dose schedule starting at birth Passive immunisation if mother eAg + (high viral load) * Single dose of HBIG Antiviral drug therapy to mother during pregnancy * Reduce viral load at time of delivery
62
Treatment of Chronic HBV Infection
Oral antiviral agents (Tenovir or Entecavir) that inhibit HBV reverse transcriptase Treatments do not cure patients but suppress viral replication. Treatment can therefore slow the progression of cirrhosis, reduce incidence of liver cancer and improve long-term survival. However, treatment must be continued for life
63
Prevention of Hepatitis C
* Screen /viral inactivation of blood products for transfusion * Safe sex * Avoid needle/syringe sharing * Avoid tattoos, piercings, and acupuncture with non-sterilised equipment * No hepatitis C vaccine
64
Treatment of Chronic HCV Infection
Direct-acting antivirals (DAAs) Treatments can now cure more than 95% of individuals infected with HCV, but access to diagnosis and treatment remains low. Blood cleared of the virus for >12 weeks following treatment with DAAs is considered a cure

Case 6 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions