EXAM #2: LIVER PATHOLOGY II Flashcards Preview

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Flashcards in EXAM #2: LIVER PATHOLOGY II Deck (60)
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1

Which Hepatitis viruses are transmitted via the fecal-oral route?

1) HAV
2) HEV

2

How is HAV commonly acquired?

Traveling

3

How is HEV commonly acquired?

1) Contaminated water
2) Undercooked seafood

4

What is the clinical manifestation of HAV or HEV infection?

Acute hepatitis; no chronic state

5

What marks active infection with HAV or HEV?

anti-HAV or HEV IgM

6

What marks prior exposure (or immunization) to HAV/ HEV?

anti-HAV or HEV IgM

7

In a patient with anti-HAV IgG antibodies, what are the possible interpretations?

1) Prior infection
2) Immunization

8

In what patient population can HEV infection lead to fulminant hepatitis?

Pregnant women

9

How is HBV transmitted?

Parenterally
- Childbirth
- Unprotected intercourse
- ID drug abuse (IVDA)

10

What is the clinical manifestation of HBV infection?

Acute hepatitis (only 20% chronic)

11

How is HCV transmitted?

Parenterally
- IVDA
- Unprotected sex

12

What is the clinical manifestation of HCV infection?

BOTH acute and chronic hepatitis

13

How is HCV infection diagnosed?

HCV-RNA

14

In evaluating a patient with HCV, what do declining HCV-RNA level indicate? What is levels remain the same?

Recovery vs. persistence/ chronic infection

15

How does then HBV virus differ from the other hepatitis viruses?

- dsDNA virus vs. ssRNA
- Hepadnavirus vs. picorna virus

16

What is HDV infection dependent on? Why?

HDV infection requires infection with HBV
- Requires HBsAg to infect (Hepatitis B Surface Antigen)

17

What is HDV coinfection?

HBV + HDV infect at the same time

18

What is HDV superinfection?

Pre-existing HBV infection THEN HDV infection

19

Which is worse, coinfection of superinfection with HDV?

Superinfection--chronic hepatitis and cirrhosis are common complications

20

What are the extrahepatic manifestations of Hepatitis B? How do these differ in adults and children?

Children= glomerulonephritis

Adults= polyarteritis nodosa

*Antigen/antibody complexes are deposits in the nephrons or medium sized vessels.

21

What are the extrahepatic manifestations of Hepatitis C?

1) Cryoglobulinemia (cold temperature induced agglutination of RBCs)
2) Thyroiditis
3) Glomerulonephritis
4) Thrombocytopenia

22

Which genotype of HCV is associated with more severe inflammation?

HCV-2

*Note that HCV-1 in the US is associated with resistance to treatment*

23

What happens with HCV and Alcoholism?

Accelerated progression to cirrhosis

24

What factors predispose HCV infection to HCC?

- Cirrhosis
- Age
- Male sex
- Alcohol

25

How does Acute Viral Hepatitis appear microscopically?

- Swelling of hepatocytes
- Cholestasis (jaundice)
- Lobular disarray (with impaired blood flow and bile flow)

26

What is a Councilman Body?

Apoptotic hepatocyte

27

How does Chronic Viral Hepatitis appear microscopically?

- Piecemeal necrosis
- Bridging fibrosis
- Nodules/ cirrhosis

28

What is the classic appearance of HBV histologically?

"Ground-glass"

29

What histologic feature is associated with HCV?

Lymphoid aggregates in portal tracts

30

What are the serologic markers for HBV infection?

1) HBsAG
2) HBcAB (core antibody) --IgM