Exam 2 HEPATITIS Flashcards Preview

Q4 Clin Med III (GI) > Exam 2 HEPATITIS > Flashcards

Flashcards in Exam 2 HEPATITIS Deck (34):
1

Hep A transmission?

Chronic?

Fecal/Oral

No

2

Hep A risk factors? (3)

Travel (50%)
Close contact
MSM

3

Hep A presentation?

Acute
Kids asympt
Prodrome: flu sxs, RUQ pain
Icteric Phase: jaundice, dark urine, pruritis, light stool

4

Hep A labs? (3)

LFT = ↑AST/ALT, ↑bilirubin
+ IgM Ab = acute infection
+ IgG Ab = immunity (past infection)

5

Hep A tx? (2)

Post-exposure?

Admit when? (3)

Supportive

Ig or vaccine for close contacts

Post-exposure:
Pts 12mo - 40yo and healthy, vaccine w/i 2wks
Otherwise IG

Hospitalize if:
Old
Co-morbidities
Underlying liver dz

REPORTABLE

6

Hep B type of virus?

Transmission?

Leading cause of what?

DNA

Blood/Body fluid

Cirrhosis and Hepatocellular CA

7

Hep B risk factors? (5)

Close contact
MSM/Multiple partners
IV drug users
Infants from mother
Health workers

95% of infected adults clear virus w/o getting dz

8

Acute Hep B presentation? (3)

Labs? (1)

Flu sxs
RUQ pain
Jaundice

LFT = ↑AST/ALT

Rarely hepatic failure

9

Chronic Hep B presentation? (4)

C asympt
Anorexia/Wgt loss
Fatigue
Heaptomegaly

10

Chronic Hep B labs? (2)

LFT = mild ↑AST/ALT
Hep B surface antigen = + > 6mo

11

Chronic Hep B complications? (2)

Cirrhosis
Hepatocellular CA

12

Hep B surface antigen (HBsAg) is?

HALLMARK OF ACTIVE INFECTION
1st marker
↑ before sx onset
Detectible ~4wks post exposure
Detectible > 6 mo = chronic infection

13

Antibody to hep B surface antigen (anti-HBs) tells us?

Signifies recovery and IMMUNITY

Hep B vaccine = + anti-HBs

14

Antibody to hep B core antigen (anti-HBc) tells us:

IgM anti-HBc?

IgG anti-HBc?

IgM anti-HBc:
Detectible shortly after HBsAg
Indicates acute or recent infection
Persists ~6 mo

IgG anti-HBc:
Indicates prior or resolving infection
Persists forever

15

Hep B envelope antigen (HBeAg) tells us?

Infective state (virus replicating)

16

Antibody to hep B envelope antigen (anti-HBe) tells us?

Lower levels of virus

17

Hep B Immunity from infection vs vaccine:

Hep B surface antibody (anti-HBs)?

Hep B core antibody IgG (anti-HBc IgG)?

Anti-HBs:
Infection = +
Vaccine = +

Anti-HBc IgG:
Infection = +
Vaccine = -

18

Hep B post-exposure prophylaxis?

IG protects
and ↓ severity if given w/i 7 days of exposure

19

Acute Hep B tx?

Admit when? (4)

Supportive
P anitviral
r/o Hep D co-inf

Admit if:
Underlying liver dz
Co-morbids
Old
Signs of failure

REPORTABLE

20

Chronic Hep B tx:

Goal?

Which pts?

F/U?

Goal:
Stop replication (-HbeAg, +anti-HBe)

Pts w/ active replication:
+HBeAg, +Hep B DNA, ↑AST/ALT

Monitor for cirro and H CA
Vaccine

21

Hep C type of virus?

Transmission?

Most C of what?

RNA

Blood/Body fluid

Chronic bloodborne infection
(80% become chronic)
Liver transplant

22

Hep C Rule of 20s?

20% infected will clear virus
20% w/ chronic will get cirrhosis w/i 20 yrs
20% of them will get H CA

23

Hep C risk factors? (5)

IV drug use
Blood trans/Clotting factors
HIV
Infants from mom
Close contact less likely

24

Acute Hep C presentation? (4)

Most are asympt
Flu sxs
RUQ pain
Jaundice

25

Chronic Hep C presentation?

Most asympt
Diagnosed from ↑ LFT w/ varying patterns

26

Hep C diagnostics?

Antibody to hep C (anti-HCV) = past or ongoing infection
If + order HCV RNA to:
1) confirm active virus
2) determine viral load
3) Determine genotype

27

Hep C management? (6)

Liver bx for staging dz
NO EtOH
No new meds w/o careful review
Screen and vacc for Hep A/B
Screen HIV
Monitor for cirro and H CA

28

Hep C pt precautions? (3)

Can't donate blood/organs
Don't share personal items
Cover open wounds

29

Hep C Rx tx?

Cured when?

Interferon + Ribavirin
6-12 mo
+ protease inhib if geno 1

Cure = no detectible virus > 6 mo

30

Hep D type of virus?

Seen when?

Delta RNA

Only as co-inf w/ Hep B

31

Hep D diagnositcs?

Delta RNA with +HBsAg
*test all Hep B pts for Hep D

32

Hep D tx?

Treat Hep B

33

Hep E type of virus?

Transmission?

E RNA

Fecal/Oral
U from travel

34

Hep E diagnostics?

Prognosis?

Tx?

Hep E RNA

Fatal in 20% of preggos,
Otherwise <1%

Supportive