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Flashcards in Hepatitis Deck (38):
1

Hep A

RNA virus. It is not cytopathic to hepatocytes, it just causes liver injury by stimulating both cellular and humoral immune responses.

2

How is Hep A transmitted?

F/O (assoc. with poor hand washing, inadequate sanitation, day care centers, etc)

3

How are epidemics of Hep A caused?

via waterborne or food borne...ie someone poops in a field and it spreads

4

T/F: there is a vaccine for Hep A?

true, it should be given when traveling to endemic areas and a booster is given at 1 year.

5

What are the symptoms of Hep A?

flu-like complaints--> abdominal pain, diarrhea, fatigue, fever, HA, myalgia, arthralgia), onset and abrupt (may include nausea and vom) usually lasts around 2 weeks. often missed. jaundice in adults self limited. most recover fully.

6

when does the Hep A antibody appear?

4 weeks after infection (IgM= acute 1-8 weeks, then IgG=past infection,>2 months). virus is in blood briefly and shed in stool.

7

How can you monitor the Hep A disease?

with liver enzymes and bilirubin. AST, ALT >3ULN. (500-1000). Urine bilirubin will be positive.

8

What kind of virus is Hep B?

DNA virus. (circulates as several particles called "dane" particles"

9

Is Hep B serious?

yes, infected patients manifest Hep B in virtually all body fluids. It can cause around 200,000-300,000 thousands death per year.

10

What body fluids can you find Hep B in?

all of them

11

How do you get Hep B?

its a blood borne pathogen so, from needles, body peircings, sexually. blood transfusions are screened.

12

How many doses is the Hep B vaccine?

Active immunization: 3 at 0,1,6 months since first dose. some people never convert. passive immunity can be conferred with HBIG.

13

Do all people recover from Hep B?

no, some progress to fulminant. chance of chronic is higher if you are younger.

14

What are the symptoms of Hep B?

onset can last 1.5-6 months. abdominal pain, diarrhea, fatigue, hepatomegaly, n/v, jaundice (30-50% of adults), urine is dark amber color.

15

What is HBsAg?

surface antigen, most widely used marker for Hep B. appears at 14 days, gone by 4 months.

16

HBcoreAg

found the core of the intact virus, no lab test for this.

17

HBcoreAB: 2 tests available

1. HBcoreAB-IgM: acute marker, becomes undetectable within 1-2 months. active disease. >6 months = chronic
2. HBcoreAB-total: detects IgG and IgM. Indicates a previous infection. This is not a protective antibody.

18

What is the core window?

occurs when B surface antigen (HBsAg) is negative but the antibody (HBsAB) hasn't been produced yet. The HBcoreAB-IgM will be positive.

19

What is the last antibody to appear, indicates clinical recovery form HBV and is the only marker found in those with the vaccine for HB?

HBsAB, it confers lifelong immunity to the HBV infection. "the surface antibody"

20

which virus requires a co infection with Hep B to replicate?

Hep D. It is an RNA particle virus.

21

What is the preferred marker for Hep D infection?

HDVAB (not HDVAg because it will only stay elevated a few days.) Does not confer immunity, people can still transmits infection.

22

T/F: there is a vaccine for Hep D?

FALSE! no vaccine. highly infectious, no immunity. Associated with drug abuse. very poor prognosis.

23

Which RNA virus has a high rate of mutation in genes of the envelope protein?

Hep c (hep b has a rare mutation rate). It allows the virus to "hide" in the body.

24

What is the most common cause of chronic hepatitis in NA, Europe, and Japan?

Hep C

25

Most with Hep C infection develop...what?

a chronic infection, (>80%) and its leads to serious liver problems down the road. cirrhosis in about 20 years.

26

How is Hep C transmitted?

body fluids, mainly blood.

27

T/F: there is no vaccine for Hep C?

true, no completely effective treatment either. you need a liver transplant.

28

Is a Hep C antibody protective?

No! patients are still considered to be infected

29

What are you looking for when testing for the presence of the HAVAB?

HAVAB-IGM (Acute infection)
HAVAB-Total (IgM and IgG, past infection)

30

who all should get the Hep B vaccine?

babies, adolescents and college students at increased risk when practicing risky life styles or sports.

31

If someone has been exposed to Hep B, what should they be given?

HBIG, within 24 hours. It is a titer agasint HBsAg.

32

What is HBeAg:

It is the envelop antigen. It is RARELY used as marker. It is typically used in patients with chronic HBV and in HBV carriers. active replication, high infectivity.

33

What is HBeAB?

envelope antibody. Typically used in patients with chronic HBV and HBV carriers. Indicates clearance of HBeAg. Could be used to see if treatment is working.

34

What would be a clinically significant measure of HBV Dna?

>100,000

35

can you tell if someone has a Hep C infection right away?

No there is an incubation period of 14-180 days.

36

What are the symptoms of Hep C?

majority are asymptomatic, maybe have vague flu like symptoms or jaundice.

37

T/F: all patients will have elevated liver enzymes with a Hep C infection?

false.
AST and ALT levels fluctuate widely after infection. Almost 1/3 of patients with chronic HCV have normal liver enzymes.

38

What are some tests to eval liver function?

AST, ALT (hepatocellular)
LD
ALT, GGT (hepatobiliary)
TSP, albumin (made in liver)
Bilirubin
Coag factors: produced in liver, patient may bleed easily.
UA: color bc of bilirubin