Hepatitis Flashcards
Hepatitis A Virus (HAV) Quiz
What type of virus is Hepatitis A?
a) Retrovirus
b) Picornavirus
c) Flavivirus
d) Coronavirus
What is the most common cause of acute viral hepatitis?
a) Hepatitis B Virus (HBV)
b) Hepatitis C Virus (HCV)
c) Hepatitis D Virus (HDV)
d) Hepatitis A Virus (HAV)
How is Hepatitis A Virus primarily spread?
a) Through sexual contact
b) Through contaminated blood transfusions
c) Through respiratory droplets
d) Through fecal-oral transmission
In which population is Hepatitis A most common, especially in areas of poor sanitation?
a) Elderly adults
b) Adolescents
c) Children
d) Pregnant women
B
D
D
C
Clinical features of HAV
Incubation period is 2–6 weeks, with mean symptom onset at 28 days.
Infection is asymptomatic in the majority of children (>70%).
Older children and adults are more likely to have symptomatic infection.
Chronic infection does not occur
Non-Icteric:
✓ No jaundice
✓ Nausea, Vomiting & diarrhea (similar to gastroenteritis)
Icteric (rare):
✓ Jaundice is present
✓ Right upper quadrant pain
✓ Headache
✓ Arthralgia
✓ Nausea, Vomiting & diarrhea
High Risk Groups of HAV infection are:
Individuals living in areas where hepatitis A is endemic (Alaska).
Travelers to Less developed or endemic areas of the world where hepatitis A is common.
Homosexual/bisexual men.
Chronic liver disease
Occupational risk (food handlers)
Frequent exposure to blood products.
Injecting drug users.
Diagnosis and complications of HAV
Diagnosis is based on serology:
Elevated IgM anti-HAV is present early and can persist for as long as 6 months after infection.
Elevated IgG anti-HAV also occurs early in infection and confers lifelong immunity.
Complications:
Fulminant hepatitis
Cholestatic hepatitis
Management and prevention of HAV
Management:
For symptomatic infection is supportive
Prevent spread to close contact:
✓ Hand washing
✓ Careful disposal of excreta, contaminated diapers or clothing, needles & other blood-contaminated items
✓ HAV vaccine (Active immunity):
Inactivated virus.
Vaccines provide long-term protection.
First dose: 12 through 23 months of age
Second dose: at least 6 months after the first dos
Give to person who travel to HAV-endemic regions
✓ Immunoglobulin (passive immunity):
Pre-exposure Immune Globulin:
Travelers to intermediate & high HAV-endemic regions (no enough time to vaccinate)
Immune globulin administration, which is effective for about 3-6 months.
Post-exposure Immune Globulin:
Within 14 days after contacts with HAV-infected person or HAV-contaminated products
What type of virus is Hepatitis B?
a) RNA virus
b) DNA virus
c) Retrovirus
d) Flavivirus
In which body fluids can HBV be found?
a) Blood only
b) Blood and urine
c) Blood, tears, saliva, semen, vaginal secretions, urine, feces, and breast milk
d) Tears and saliva only
Which of the following is NOT a common mode of transmission for HBV?
a) Perinatal vertical exposure from an infected mother to her fetus
b) Parenteral route through exposure to infected blood products tattooing needles & IV drug use
c) Exposure to infected body secretions
d) Airborne transmission
What is the perinatal route of HBV transmission?
a) Transmission through respiratory droplets
b) Transmission through contaminated water
c) Transmission from an infected mother to her fetus
d) Transmission through sexual contact
B
C
D
C
Clinical features of HBV
➢ Incubation period is 45–160 days with mean symptom onset of 90 days
➢ Symptoms are extremely variable, ranging from asymptomatic infection to nonspecific systemic illness to clinical hepatitis and fulminant liver failure
➢ Acute symptoms of hepatitis occur in:
✓ <5% of infants
✓ 5–15% of preschool children
✓ 30–50% of older children and adolescents.
➢ Chronic HBV infection:
✓ Is most common in young infants who acquire the virus from perinatal exposure
✓ Is less common in older children
✓ Chronic HBV infection may result in chronic liver disease with:
Cirrhosis
Hepatic fibrosis
Portal hypertension
Increased risk for hepatocellular carcinoma
Treatment Nucleotide and nucleoside analogues
Diagnosis of HBV (جدول صفحه ٨)
Diagnosis is on the basis of serology
HEPATITIS C VIRUS (HCV)
Transmission
Clinical features
Diagnosis
❖ RNA virus in the flavivirus family
❖ Transmission is by perinatal vertical route from mother to fetus or by parenteral exposure
❖ HCV accounts for:
➢ 90% of transfusion-associated hepatitis
➢ 50% of “non-A, non-B” hepatitis.
❖ Clinical features:
➢ Acute infection is rarely symptomatic (especially in children)
➢ Chronic infection:
✓ May result in cirrhosis and hepatic fibrosis
✓ Occurs in 85% of infected patients
✓ Treatment: Protease and polymerase inhibitors
❖ Diagnosis is by serology:
HCV antibody in the blood.
HCV PCR is used as a confirmatory test for chronic infection.
HEPATITIS D VIRUS (HDV):
Diagnosis
Transmission
May cause
❖ RNA virus
❖ Requires HBsAg for replication.
❖ Transmission is by parenteral exposure
❖ May cause progression of hepatitis B infection, or may precipitate fulminant liver failure.
❖ Diagnosis is by serology: HDV antigen and antibody.
HEPATITIS E VIRUS (HEV):
Diagnosis
Transmission
Cause
❖ RNA virus
❖ Transmission is by fecal–oral route
❖ Hepatitis E is responsible for:
➢ 50% of acute hepatitis in young adults in developing countries
➢ Associated with 20% mortality in infected pregnant women.
❖ Chronic disease does not occur
❖ Diagnosis is by serology demonstrating HEV antibodies.
PTT FOR hepatitis
الجدول صفحه ١٠
The prothrombin time is a good predictor of severe hepatocellular injury and progression to fulminant hepatic failure
