Flashcards in EXAM #2: LIVER PATHOLOGY II Deck (60)
Which Hepatitis viruses are transmitted via the fecal-oral route?
How is HAV commonly acquired?
How is HEV commonly acquired?
1) Contaminated water
2) Undercooked seafood
What is the clinical manifestation of HAV or HEV infection?
Acute hepatitis; no chronic state
What marks active infection with HAV or HEV?
anti-HAV or HEV IgM
What marks prior exposure (or immunization) to HAV/ HEV?
anti-HAV or HEV IgM
In a patient with anti-HAV IgG antibodies, what are the possible interpretations?
1) Prior infection
In what patient population can HEV infection lead to fulminant hepatitis?
How is HBV transmitted?
- Unprotected intercourse
- ID drug abuse (IVDA)
What is the clinical manifestation of HBV infection?
Acute hepatitis (only 20% chronic)
How is HCV transmitted?
- Unprotected sex
What is the clinical manifestation of HCV infection?
BOTH acute and chronic hepatitis
How is HCV infection diagnosed?
In evaluating a patient with HCV, what do declining HCV-RNA level indicate? What is levels remain the same?
Recovery vs. persistence/ chronic infection
How does then HBV virus differ from the other hepatitis viruses?
- dsDNA virus vs. ssRNA
- Hepadnavirus vs. picorna virus
What is HDV infection dependent on? Why?
HDV infection requires infection with HBV
- Requires HBsAg to infect (Hepatitis B Surface Antigen)
What is HDV coinfection?
HBV + HDV infect at the same time
What is HDV superinfection?
Pre-existing HBV infection THEN HDV infection
Which is worse, coinfection of superinfection with HDV?
Superinfection--chronic hepatitis and cirrhosis are common complications
What are the extrahepatic manifestations of Hepatitis B? How do these differ in adults and children?
Adults= polyarteritis nodosa
*Antigen/antibody complexes are deposits in the nephrons or medium sized vessels.
What are the extrahepatic manifestations of Hepatitis C?
1) Cryoglobulinemia (cold temperature induced agglutination of RBCs)
Which genotype of HCV is associated with more severe inflammation?
*Note that HCV-1 in the US is associated with resistance to treatment*
What happens with HCV and Alcoholism?
Accelerated progression to cirrhosis
What factors predispose HCV infection to HCC?
- Male sex
How does Acute Viral Hepatitis appear microscopically?
- Swelling of hepatocytes
- Cholestasis (jaundice)
- Lobular disarray (with impaired blood flow and bile flow)
What is a Councilman Body?
How does Chronic Viral Hepatitis appear microscopically?
- Piecemeal necrosis
- Bridging fibrosis
- Nodules/ cirrhosis
What is the classic appearance of HBV histologically?
What histologic feature is associated with HCV?
Lymphoid aggregates in portal tracts