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Flashcards in Hepatits Deck (31):
1

Which hepatitis are mostly co infections?

B and D

2

Hepatitis E is worst in.... And found mainly in which part of the world?

Pregnancy
East asia

3

Which hepatitis can be acquired perinatally?

B, C, D (sex, blood, mom)

4

Which hepatitis can you acquire with consuming water or food?

A and E

5

Which hepatitis rarely presents in acute form?

C

6

Sx of hepatitis

Jaundice, fever, weight loss, fatigue, dark urine, hepatosplenomegaly, abdo pain

7

What does the lab look like in viral hepatitis?

Increased direct bili, increased ALT>AST (viraL), increased alkaline phosphatase, aplastic anemia is a rare complication

8

What test in hepatitis correlates with increased mortality?

Prothrombin time: 70-80% of the liver is dead if prothrombin time is up (all coag factors are made in liver except 8 and VWF)

9

Best initial test for hepatitis A, C, D and E?

IgM antibody: acute infection
IgG antibody: resolution of infection

10

Hepatitis C disease activity measured with

PCR RNA level : amount of active viral replication
If PCR rises it shows treatment failure

11

Serologic pattern for hep B

Surface antigen: indicates presence of virus; + in acute or chronic infections, - in resolved infection
E antigen: degree of viral replication
Surface antibody if + could be vaccine, so look at core (vaccine gives no core), if core + then it means resolved, past infection if IgG, acute or chronic if IgM or IgG

12

Serology hep B window period

Surface antigen, e antigen and surface antibody negatives
Core antigen positive IgM then IgG

13

Which serologic marker becomes abnormal first in hep B?

Surface antigen

14

Which serologic marker in hep B correlates directly with the amount of viral replication?

E antigen

15

Which serologic marker in hepatitis B shows the infection is on the way to resolution?

Anti hep B e antibody

16

The best serologic marker in hep B that indicates that a woman can transmit the disease to her baby is?

E antigen 90% chances!

17

A carrier of hep B would have which serology?

Surface antigen + and that is it

18

Which markers in hep B would indicate that you cannot transmit the infection

No surface antigen found

19

Which is the best indication of the need for treatment in chronic hepatitis B?

E antigen

20

What is the treatment for hep A?

Resolves spontaneously over weeks, almost always benign

21

What is the treatment for hep E?

Resolves spontaneously over weeks, almost always benign

22

What is the percentage of hep B that becomes chronic?

10%

23

What is the treatment for acute hep B?

None

24

What is the treatment for acute hep C?

Interferon, ribavirin and either telaprevir or boceprevir, decreases likelihood of developping chronic infection

25

Chronic hepatitis B is dx when

Surface antigen is positive for longer than 6 months

26

When to treat for chronic hep B?

Both surface antigen + (more than 6 months) and e antigen +

27

What is the tx for hep B?

(one drug!)
Entecavir or adefovir or tenofovir or lamivudine or telbivudine or interferon (but has lots of adverse effects and no greater efficacy - flu like sx, plus it is injectable)

28

Adverse effects of interferon?

Arthralgia, myalgia, leukopenia, thrombocytopenia, depression and flu like sx

29

Goal of hep B therapy?

Convert e antigen in e antibody

30

What test determines if you treat hep C?

PCR-RNA viral load elevated : treat with 3 drugs interferon ribavirin and either telaprevir or boceprevir

31

What are side effects of ribavirin?

Anemia