Clin Med II - GI Exam > Hepatitides > Flashcards

Hepatitides Flashcards

(57 cards)

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1
Q

Risk factors for liver dz?

A 
ETOH 
Hyperlipidemia, obesity, DM
Previous blood transfusion (esp. before 1992)
Autoimmune dz
IVDU
High risk sexual behavior
foreign travel
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2
Q

What labs are included in LFT’s?

A 
Bilirubin
Albumin
Total Protein
ALP
AST
ALT
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3
Q

What lab can be used as adjunct to LFT’s to determine hepatocyte injury more specifically?

A

GGT

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4
Q

Where is bilirubin conjugated?

A

Liver

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5
Q

Where is albumin synthesized?

A

liver

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6
Q

Where does AST originate?

A

Hepatocytes and skeletal and cardiac muscle

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7
Q

Where does ALP originate?

A

Hepatocyte, bone, intestine, and placenta

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8
Q

What are the two types of hepatotropic viral infections that can occur?

A

Acute

Chronic

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9
Q

How is Hep A transmitted?

A

Fecal-oral transmission

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10
Q

Where does viral replication occur in Hep A?

A

in the liver

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11
Q

How long does it take for virus to be found in blood/feces after infection of Hep A?

A

10-12 days

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12
Q

How long might viral excretion occur after onset of symptoms in Hep A?

A

3 weeks

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13
Q

In Hep A children are generally symptomatic/asymptomatic?

A

asymptomatic

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14
Q

in Hep A adults are generally symptomatic/asymptomatic?

A

symptomatic

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15
Q

When is the greatest probability of communicability in Hep A?

A

2 weeks before onset of jaundice

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16
Q

How long will the Hep A virus be in the environment for after exposure?

A

months

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17
Q

Risk factors for Hep A?

A

close contact
Ingestion of contaminate food/water
Blood exposure
Incubation (28-30 days)

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18
Q

Tx for Hep A?

A

IG-passive transfer of neutralizing antibodies

Prevents infection or clinical expression of dz

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19
Q

How long does pre-exposure prophylaxis last for Hep A?

A

3-5 mos

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20
Q

How soon after exposure must pt’s be given post-exposure prophylaxis for Hep A?

A

within 14 days

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21
Q

How many doses are required for Pre-expsure Hep A vaccine?

A

2

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22
Q

How old must a pt be to receive the Hep A vaccine?

A

older than 1 year (and before 24 mos. preferrably)

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23
Q

How long does the Hep A vaccine last?

Study These Flashcards
A

at least 20 years (unsure)

24
Q

What is the MC source of HBV infection in US?

Study These Flashcards
A

Heterosexual contact

25
What is the most likely reason for decrease in viral hep A in US?
Universal vaccinations even for those not at risk
26
Considering risk factors for HBV infection which body fluid increases the concentration of virus?
Blood and serum (+wound exudate)
27
If you get HBV as an infant was is the risk that it will become chronic?
90%
28
What do we look for in a serum draw to see if Hep B virus is still present?
HBsAg | HBeAG tells us it's still active
29
If a mother is positive for HBsAG and HBeAg what is the risk % of her child becoming infected?
70-90%
30
If a mother is positive for HBsAG only what is the risk % of her child becoming infected?
5-20%
31
What is used to prevent HBV infection?
HBIG (post exposure) HBVaccine (Pre and post exposure) Currently: Vaccine for infants and everyone else!!
32
What is the primary component of the HBV vaccine?
HBsAg
33
what was the HCV outbreak in NH due to in 2012?
diversion of narcotics in cardiac cath lab
34
Why has there been a decrease of HCV infection reported?
number of acute clinical cases underreported
35
What percent of those who contract HCV go on to have a persistent infection?
Majority! 75-80%
36
What risk factor is HUGE with HCV!!??
ETOH use
37
What carries a higher risk of contraction of HCV IVDU or Sexual intercourse?
IVDU
38
Clinical presentation of HCV?
80% asymptomatic | loss of appetite, abdominal pain, fatigue, nausea, dark urine, jaudice
39
How is HCV diagnosed?
IgG assay for anti-HCV (may have false negative in first 15 weeks) Nucleic acid amplification test
40
Tx for HCV?
in the process of evolving now. | Pegylated interferon and ribavirin for 24-48 wks - 50% success (sustained viral response)
41
What other virus does Hep D require in order to be contracted?
HBV
42
What 2 different ways can Hep D be acquired?
confection with HBV at same time | Superinfection with HBV already present
43
What vaccine exists for Hep D?
Hep B vaccine! BC you need Hep B to get Hep D
44
Which is it more common for a pt to have fulminant liver failure in a pt with Confection HDV or Superinfection HDV
Superinfection (5%)
45
How is Hep E transmitted?
Fecal Oral
46
Where is Hep E virus more common?
Japan, and europe (zoonotic and foodborne)
47
What are the 2 phases of the Hep E virus?
Prodromal | Icteric
48
Prodromal phase of HEV presentation
``` Myalgia arthralgias fever mild temp elevation anorexia N/V Wt loss Dehydration RUQ pain increased with activity ```
49
Icteric phase of HEV presentation?
Jaudice (serum bili is greater than 3) Dark urine Light colored stool Pruritis
50
How is HEV diagnosed?
Anti-HEV IgM and IgG in serum HEV RNA in serum/stool confirms serologic (seldom required) No diagnostic tests have been approved by the FDA yet.
51
TX for HEV?
supportive
52
Prevention for travelers concerned with HEV?
no vaccine/drug available | avoid possible contaminants (meat, water, etc)
53
Prognosis for HAV?
usually mild/self limited infection confers lifelong immunity Rare complications: relapse, cholestatic hepatitis, FHF
54
Prognosis for HBV?
Risk of chronic infection high in younger children | FHF develops in small present but fatality in those is high
55
Prognosis of HCV?
Chronic infxn common (50-60%) at risk for chronic active hepatitis, cirrhosis High death rate
56
Prognosis of HDV w/ co-infected HBV:
Chronic HDV is common | Rapildy progressive acute/subacute hepatitis 70-80% develop into cirrhosis
57
Prongnosis of HEV?
mild-self limiting Case fatal in higher in pregnant women does not result in chronic dz
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