L13/14 - HepC (1)

Question 1

What Hep viruses are non-envelped?

Answer 1

HepA

HepE

Question 2

What Hep viruses are enveloped?

Answer 2

HepB
HepC
HepD

Question 3

How are non-enveloped Hep viruses transmitted?

Answer 3

Enteric

Question 4

How are enveloped Hep viruses transmitted?

Answer 4

parenteral

Question 5

Function of hepatocytes?

Answer 5

Metabolise carbs, fats, proteins

produce serum components

Detoxify

Produce Bile

Question 6

Which Hep viruses are released into the blood?

Answer 6

Hep B/C/D

envelopes cannot handle acidic environment of bile

Question 7

Which Hep viruses are released into the bile?

Answer 7

Hep A/E

stable within acidic/detergent environment

Question 8

How does blood enter the liver?

Answer 8

Sinusoids

Question 9

How many genotypes of HCV?

Answer 9

7

Question 10

What genotypes of HCV are most common in W. Europe?

Answer 10

Type 1-3

Question 11

Why is there a high incidence of HCV in Egypt?

Answer 11

Treatment campaign Schistosomiasis in 1960s

re-used glass syringe, emetic tartar

Question 12

Original name fo HCV?

Answer 12

NANBH

Question 13

How was HCV cloned?

Answer 13

serum centrifuged
RNA extracted 
Reverse transcribed
clone into lambda bacteriophage
Infect E.coli with bacteriophage library

imprint plate using nitrocellulose membrane
probe membrane with antiserum from infected patients

Question 14

What family is HCV a member of?

Answer 14

Flaviviridae

Question 15

Structural proteins of HCV?

Answer 15

Core
E1
E2
(p7)

Question 16

Non-structural proteins of HCV?

Answer 16

(p7)
NS2
NS3
NS4A
NS4B
NS5A
NS5B

Question 17

What is the p7 protein of HCV?

Answer 17

ion channel

Question 18

What % of acute hepatitis cases lead to chronic liver disease?

Answer 18

<85%

Question 19

What are ALT?

Answer 19

Allanine amino transferase - usually present in hepatocyte

Question 20

What does elevated levels of ALT cause?

Answer 20

Cirrhosis and potentially Hepatocellular carcinoma

Question 21

Are levels of ALT always the same?

Answer 21

titres can fluctuate over years - virus not cleared

Question 22

What is liver fibrosis?

Answer 22

scar tissue in liver underneath hepatocyte

restricted blood supply

Question 23

Link between HCV and insulin resistance?

Answer 23

HCV disrupts pathway and increases cytokine production of IL18 and TNF-a

Question 24

What other effects does insulin resistance have on the body?

Answer 24

Type II diabetes

Reduced antiviral response

Increased incidence of HCC

Accelerated fibrogenesis

Question 25

Link between HCV and lipid metabolism?

Answer 25

Core associates with lipid droplets lipid accumulation NS5A - dramatic increase in amount of lipid droplet Hepatocytes are lipid producers - transported ELSEWHERE

Question 26

What processes are increased in lipid metabolism during HCV infection?

Answer 26

Lipogenesis

Question 27

What processes are decreased in lipid metabolism during HCV infection?

Answer 27

Lipoprotein secretion Fatty acid oxidation

Question 28

What fatty liver condition does HCV lead to?

Answer 28

Steatosis

Question 29

What is Steatosis?

Answer 29

effects of core and NS5A proteins enhanced by lifestyle Genotype-specific

Question 30

Which genotype does Steatosis have a higher incidence in?

Answer 30

Genotype 3

Question 31

What is HCC?

Answer 31

Hepatocellular carcinoma

Question 32

How does HCC develop?

Answer 32

Chronic liver injury Inflammation Increased cell turnover Oxidative DNA damage

Question 33

How is the liver repaired?

Answer 33

Move out fo G0 into cell cycle divide to repair liver

Question 34

What does Wnt/B-cantenin control?

Answer 34

gene expression

Question 35

What molecular requirements INCREASE for development of HCC?

Answer 35

Cell cycle Vascularisation Gene expression

Question 36

What molecular requirements DECREASE for development of HCC?

Answer 36

apoptosis

Question 37

What does p53 control?

Answer 37

apoptosis

Question 38

What does TGFb (retinoblastoma oncogene) control?

Answer 38

apoptosis and Cell cycle

Question 39

What HCV proteins are involved with p53?

Answer 39

NS5A Core NS3

Question 40

What HCV protein are involved with TGFb?

Answer 40

NS5A | Core

Question 41

What HCV proteins are involved with Rb?

Answer 41

NS5B

Question 42

What HCV proteins are involved with Growth factors and Wnt/B-cantenin?

Answer 42

NS5A