Hepatitis

Question 1

Clinical

Answer 1

Primary Acute phase= systemic = flu like (fever and myalgia)

Add’l = Jaundice, dark urine (bilirubinuria), light stools (decreased bile), itch, hepatosplenomegaly, increased AST and ALT

Question 2

Flaviviridae: Yellow Fever Virus Clin

Answer 2

Hepatitis. Mild to severe (GI hemo and black emesis). Progression to include infection of kidneys and liver (likes fixed macrophages)

Question 3

Flaviviridae: Yellow Fever Virus char

Answer 3

ss pos sense RNA virus; enveloped

Infects dendritic cells, macrophages, monocytes and hepatocytes

Question 4

Flaviviridae: Yellow Fever Virus Res

Answer 4

Animals

Question 5

Flaviviridae: Yellow Fever Virus RF

Answer 5

Unvccn travelers to SAfrica and SAmerica

Question 6

Flaviviridae: Yellow Fever Virus Trans

Answer 6

Mosquitos

Question 7

Flaviviridae: Yellow Fever Virus Diag

Answer 7

Serology

Question 8

Flaviviridae: Yellow Fever Virus Vccn

Answer 8

Live attenuated

Question 9

Leptospira Interogens Clinical

Answer 9

Leptospirosis. Asymp to mild hepatitis. May progress to severe hemorrhagic disease.

Question 10

Leptospira Interogens Char

Answer 10

Gram neg spirochete with bent ends

Question 11

Leptospira Interogens VF

Answer 11

Hyaluronidase

Question 12

Leptospira Interogens Res

Answer 12

Animals; survive in water/soil up to 3 months

Question 13

Leptospira Interogens Trans

Answer 13

Direct/Indirect

Question 14

Leptospira Interogens RF

Answer 14

Exposure to animal urine and water sports

Question 15

Leptospira Interogens Diag

Answer 15

Paired sera; darkfield microscopy; PCR; Elisa; Agglutination

Question 16

Leptospira Interogens Prvt

Answer 16

Rodent Control

Question 17

Leptospira Interogens Comp/Seq

Answer 17

Well’s disease = Kid fail (increased creatinine)

Question 18

Viral Cytopathology HAV and HEV

Answer 18

Both lack an envelope; stable in enviro (fecal oral). Cytopath = lytic so constantly provide extracell targets for IR. Generally no comp/seq or chronicity

Question 19

Viral Cytopathology HBV and HCV

Answer 19

Both have envelope; not stable in enviro so body fluids required. Cytopath = budding and CTL/NK removal of infected cells. If inadequate IR = chronicity and clinical progression to cirrhosis and hepatocell carcinoma

Question 20

Viral Cytopathology HDV

Answer 20

Defective virus; has an envelope. Can’t replicate w/o HBV

Question 21

Picornaviridae: HAV Clin

Answer 21

Hepatitis. Enterically transmitted. IP=28 days. Dur = 2wks to 3 months. No chronic

Question 22

Picornaviridae: HAV Char

Answer 22

ss pos sense RNA viruse non-env

Question 23

Picornaviridae: HAV trans

Answer 23

Fecal oral; low inf dose. Close personal contact: household, daycares; analingus. Contaminated food, drinking water: food handlers, raw shellfish, certain produce

Question 24

Picornaviridae: HAV RF

Answer 24

Unvccn

Question 25

Picornaviridae: HAV Diag

Answer 25

IgM = acute; IgG = post inf

Question 26

Picornaviridae: HAV Vccn

Answer 26

Inact and live attenuated (Ig passive for post exp)

Question 27

Hepeviridae: HEV Clin

Answer 27

Entericall trans hepatitis. IP - 40 days. Dur - 4 to 6 wks. Rare fulminating disease. Reactivation in immunocomp.

Question 28

Hepeviridae: HEV Char

Answer 28

ss pos sense RNA virus; non env

Question 29

Hepeviridae: HEV Res

Answer 29

Humans and animals

Question 30

Hepeviridae: HEV Trans

Answer 30

Fecal oral, some transplacental

Question 31

Hepeviridae: HEV RF

Answer 31

Shellfish, high mortality in third trimester preggo. Eastern and South Asia

Question 32

Hepeviridae: HEV Diag

Answer 32

Indistinguishable from Hep A. IgM for acute, IgG for post inf

Question 33

Hepadnaviridae: HBV Char

Answer 33

Partially ds circular DNA virus; enveloped

Question 34

Hepadnaviridae: HBV Res

Answer 34

Humans

Question 35

Hepadnaviridae: HBV Trans

Answer 35

Parental, sexual, perinatal

Question 36

Hepadnaviridae: HBV RF

Answer 36

Unvccn, IDU; neonates of chronic mother

Question 37

Hepadnaviridae: HBV Prvt

Answer 37

Recombinant vccn (subunit with s proteins), HBV IgG post/pre-exposure in aprop populations. Infant = active and passive immunizations w/in 12 hrs of birth

Question 38

Hepadnaviridae: HBV Clin

Answer 38

IP = 60 to 90 days. Hepatitis

Question 39

Hepadnaviridae: HBV Diag

Answer 39

``` HBsAg - general marker of infection HBsAb - documents recovery HBcIgM - acute HBcIgG - chronic HBeAg - active replication, high trans HBeAb - virus not rep, low trans ```

Question 40

Hepadnaviridae: HBV Window Period

Answer 40

both seromarkers HBsAg and Anti-HBs are neg because theyr are bound to each other. Other markers HBcIgM can be pos at this point.

Question 41

Hepatitis D Virus Clin 1

Answer 41

Coinfection with HBV. Acute disease similar to HBV alone or slightly more symptomatic. low risk of chronic infection

Question 42

Hepatitis D Virus Clin 2

Answer 42

Superinfection. On top of chronic HBV. Results in the most svr acute disease cases. Usually develop chronic HBV/HDV infection. High risk of liver failure.

Question 43

Hepatitis D Virus Char

Answer 43

Defective ss neg sense RNA virus; enveloped w/ HBsAg inserted

Question 44

Hepatitis D Virus Res

Answer 44

Humans

Question 45

Hepatitis D Virus Trans

Answer 45

Parenteral routes

Question 46

Hepatitis D Virus Diag

Answer 46

Serology - Total Ag

Question 47

Hepatitis D Virus Tx

Answer 47

Treat HBV

Question 48

Flaviviridae: HCV Clin

Answer 48

Hepatitis. Most new infections subclinical with 90% chronic leading to cirrhosis and heptocellular carcinoma

Question 49

Flaviviridae: HCV Char

Answer 49

ss pos sense RNA virus, enveloped; 6 genotypes

Question 50

Flaviviridae: HCV Res

Answer 50

Humans

Question 51

Flaviviridae: HCV Trans

Answer 51

Parenteral (decreased sexual; fetus)

Question 52

Flaviviridae: HCV RF

Answer 52

IDU, Tatoo, hemodialysis, use of blood products

Question 53

Flaviviridae: HCV Diag

Answer 53

Serology for total Ig; PCR

Question 54

Flaviviridae: HCV Tx

Answer 54

Pegylated IFN-alpha/ribavirin. | Telaprevir (protease inhib) which inhib rep