Chapter 43- Viral hepatitis

Question 1

what is hepatitis

Answer 1

a clinical syndrome characterized by inflammation of the liver

Question 2

what causes jaundice in hepatitis

Answer 2

hepatocyte death releases bilirubin

Question 3

what is bilirubin

Answer 3

a biproduct of heme metabolism in the liver

Question 4

what are the causes of hepatitis

Answer 4

-viral: hepatitis viruses A-E, herpes viruses (HSV,EBV,CMV), adenovirus, yellow fever virus
- alcohol
- toxins

Question 5

where do hepatitis viruses replicate and why

Answer 5

in the hepatocyte because they have a strong tropism for the liver

Question 6

85% of liver cells are _____

Answer 6

hepatocytes

Question 7

what is infectious hepatitis also known as, what, letters is it, and what causes it

Answer 7

• “hit and run”
• A and E
• fecal- oral

Question 8

what is serum hepatitis also known as, what letters is it and what causes it

Answer 8

• “hide and infiltrate”
• B, C and D
• blood and sexual fluid

Question 9

what is the nucleic acid composition and virus family of Hepatitis A

Answer 9

• linear and ssRNA
• picornaviridae

Question 10

describe hepatitis A and what causes it

Answer 10

• infectious hepatitis
• HAV: isocahedral, naked capsid virus, positive strand linear RNA
• spread by fecal- oral contamination of food, drink or shellfish

Question 11

what is HAV shed into and what does it directly kill

Answer 11

• shed into bile ducts and into intestine and passes out of the body in the feces
• HAV directly kills hepatocytes

Question 12

what are the clinical manifestations of hepatitis A

Answer 12

• mild intestinal infection
• viremia occurs occasionally, leading to liver infection and jaundice

Question 13

what is the treatment, prevention and control of hepatitis A

Answer 13

• killed HAV vaccine
• post exposure immune globulin

Question 14

which adults are more likely to display symptoms of hepatitis A

Answer 14

adults from nonendemic regions

Question 15

how big is the genome of hepatitis B

Answer 15

• smallest genome
• 3200 nucleotides

Question 16

what is the nucleic acid composition and virus family of Hepatitis B

Answer 16

• nicked circular
• mostly dsDNA
• hepadnaviridae
• enveloped

Question 17

what are the 3 distinct particles of hepatitis B

Answer 17

• 22nm particle
• variable tubular/ filamentous particle (22nm diameter)
• 42nm Dane particle (infective form of virus)

Question 17

what is the main component of the envelope in hepatitis B and where is it located

Answer 17

• embedded in lipid bilayer
• HBsAg-S is main component

Question 18

HBeAg is processed form of the core:

Answer 18

HBcAg

Question 19

what is HBeAg mostly secreted from and where is it found

Answer 19

infected cells and found in the blood stream

Question 20

what is a useful marker for HBV infection

Answer 20

HBeAg

Question 21

filaments are enriched for ______

Answer 21

HBsAg-L

Question 22

describe both types of 22nm particles

Answer 22

-empty envelopes
- spherical
- up to 10^13 particles per mL

Question 23

When does RT occur in hepatitis B

Answer 23

during viral assembly

Question 24

what is reverse transcription done by in hepatitis B

Answer 24

viral reverse transcriptase

Question 25

what is transcription done by in hepatitis B

Answer 25

host RNA polymerase

Question 26

how is priming of reverse transcription done

Answer 26

by TP (terminal protein domain) of viral polymerase by adding first nucleotide to a tyrosine residue of TP

Question 27

what determines the course of HBV infection

Answer 27

CMI

Question 28

what do CTLs kill in HBV infection

Answer 28

infected hepatocytes

Question 29

what are the ouctomes of acute HBV infection

Answer 29

- 90% resolution - 9% HBsAg+ for greater than 6 months - 1% fulminant hepatitis - HBsAg+ causes resolution or chronic active hepatitis - chronic active hepatitis causes cirrhosis or hepatic cell carcinoma

Question 30

what percentage of infants infected with HBV become chronically infected and why

Answer 30

90% because of immature cell mediated immune response

Question 31

what causes hepatocellular carcinoma

Answer 31

- increased cell division due to regeneration increases chances of mutation -peroxides and free radicals from CTL killing

Question 32

how does HBV kill hepaocytes

Answer 32

-indirectly - CTLs directed against MHC class I proteins bound to viral antigens on hepatocyte surface - cytokine release promotes inflammation and tissue damage

Question 33

what would you be positive for if prior vaccination for hepatitis B

Answer 33

- Anti HBs

Question 34

what would you be positive for if prior acute infection, resolved

Answer 34

-Anti HBe - Anti- HBc - Anti HBs

Question 35

what would you be positive for if acute or chronic hepatitis B infection

Answer 35

- HBeAg - Anti HBc - HbsAg

Question 36

what would you be positive for if you had later stage in chronic infection of hepatitis B

Answer 36

- HbsAg - Anti- HBc - Anti- Hbe

Question 37

what is the treatment, prevention and control for hepatitis B

Answer 37

- vaccination recommended for all infants in USA - HBsAg particles produced in yeast - passive immunotherapy within 7 days of exposure - reverse transcriptase inhibitors

Question 38

what is the nucleic acid composition and virus family of hepatitis D

Answer 38

- circular ssRNA - deltaviridae

Question 39

what does hepatitis D virus depend on to replicate

Answer 39

HBV virus

Question 40

what is a chronic HBV infection exacerbated by

Answer 40

infection with hepatitis delta virus

Question 41

what is the nucleic acid composition and virus family of hepatitis C

Answer 41

- linear and ssRNA - flaviviridae

Question 41

what is a chronic HBV infection exacerbated by

Answer 41

infection with hepatitis delta virus

Question 41

describe hepatitis C and how it is transferred to others

Answer 41

- enveloped - blood and sexual fluid, mother to fetus, fecal- oral route, and organ transplants

Question 41

how does HCV kill hepatocytes

Answer 41

-indirectly - CTLs directed against MHC class I proteins bound to viral antigens on hepatocyte surface - cytokine release promotes inflammation and tissue damage

Question 42

what are the outcomes of hepatitis C virus acute infections

Answer 42

- 15% recovery and clearance - 15% cirrhosis rapid onset - 70% persistent infection

Question 43

what are the outcomes of chronic hepatitis

Answer 43

- 20% cirrhosis - 6% liver failure - 4% hepatocellular carcinoma

Question 44

what is mixed cryoglobulinemia

Answer 44

-immune complex disease of kidney and other sites - disease outside of liver - inflammation and blockage of small and medium blood vessels caused by cryoglobulin deposition

Question 44

what is the nucleic acid composition and virus family of hepatitis E

Answer 44

- linear and ssRNA - calciviridae

Question 44

describe hepatitis E and how its spread

Answer 44

- not budding, released as naked capsid virus - spread in contaminated food and drink, human to human and animal to human (common source = pigs)