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OBGYN microbiology > L26 BW (viral hep) > Flashcards

L26 BW (viral hep) Flashcards

1
Q

HBsAg (-)

total anti-HBc (-)

anti-HBs (-)

A

susceptible

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2
Q

what makes fulminant (aka super severe) hepatitis more likely

A

HBV/HDV infection

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3
Q

what is a big concern about HBV and why

A

chronic infection b/c 10% will develop cirrhosis and liver failure

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4
Q

HBsAg

A

****HBV surface antigen *****

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5
Q

what is it called when you get HDV after you already have HBV

A

superinfection

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6
Q

what is a good test for HCV

A

OraQuick HCV- a new rapid test to reveal antibody

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7
Q

HDV prevention

A

the HBV vaccine

also PEG interferon to tx

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8
Q

which hep is far more likely to establish chronic infections

A

HCV

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9
Q

HBV complications

A

cirrhosis, liver cancer

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10
Q

what antibodies and antigens you will see in HBV window

A

anti HBe (anti- infectious surface fragments)

total anti-HBc

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11
Q

HAV transmission

A

food and water borne; virions are excreted in feces

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12
Q

continued detection of what antigens reveals a probably chronic state of HBV

A

HBeAg and HBsAg

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13
Q

acute icteric hepatitis consists of what phases

A

incubation

prodrome (fatigue, malaise, anorexia)

icteric phase (jaundice, hepatolmegaly, elev liver enzymes)

convalescent phase (disappearnace of sxs)

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14
Q

what increases the severity of HBV infections

A

HDV

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15
Q

what antibodies and antigens are you going to see there is

resolution after the onset of HBV and it

does NOT progress to chronic

A

antibodies to surface/ surface fragment antigens and totaly anti-HBc

IgG- anti HBs (anti-surface)

anti-HBe (anti- infectious surface fragments)

total anti-HBc

no antigens

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16
Q

which types are chronic

A

B, C, D *******

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17
Q

IgG anti- HBs

(antibody to surface antigen)

indicates

A

chronic disease

(with previous exposure)

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18
Q

what % of infants infected with HBV will become chronically infected

A

90%

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19
Q

HBsAg (+)

total anti-HBc (+)

IgM anti-HBc (-)

anti-HBs (-)

A

chronically infected

dont have IgM and anti HBs b/c

IgM anti-HBc would only be there if it were a new infection

anti-HBs doesn’t develop until way late in the game for people w/ chronic infection

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20
Q

convalescent phase

A

disappearance of jaundice and other sxs

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21
Q

what has reduced risk of infection from blood and blood products

A

serological screening

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22
Q

how many genotypes of HCV

A

6 genotypes and 50 subtypes

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23
Q

D incubation period

A

1-6 months

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24
Q

tx for HCV

A

direct acting antiviral agents that specifically antagonize virus functions

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25
Q

what is it called when you get HDV and HBV at the same time

A

coinfection

can be more rapid and severe

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26
Q

when is HBV shed

A

during asymptomatic periods

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27
Q

C incubation period

A

2-24 weeks (but mostly 6-7 weeks)

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28
Q

HBsAg (-)

total anti-HBc (-)

anti-HBs (+)

A

immune due to vaccine

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29
Q

what antibodies and antigens you will see in HBV onset

A

first

HBsAg- surface antigen (initial villain)

then

HBeAg- surface fragments (infectious particles)

IgM- anti HBc (anti-core) (police)

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30
Q

detection of what antigen is best ID an infectious HBV virus

A

HBeAg

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31
Q

hallmark of HCV

A

chronic infection

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32
Q

HBV dx

A

serum showing antibodies and antigens

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33
Q

total anti-HBc indicates

A

exposure

could be current, could be chronic, could be resolved

34
Q

what do pts with HAV need to avoid

A

hepatotoxins- alcohol, drugs, anesthesia

35
Q

what factors promote HCV progression

A

ETOH, infection after 40, male, HBV co-infection, HIV co-infection

36
Q

for many cases of HCV, the source of infection is ___

A

unknown- many at risk pts don’t know they should be tested

37
Q

Ig M- anti HBc

(antibody to core)

indicates

A

new exposure

only around for the acute exposure

won’t be present in chronic or w/ resolution

38
Q

major risk factor for HAV

A

contact with infected family member

39
Q

HCV drug regimens vary by

A

virus genotype

40
Q

prodrome, aka what? sxs?

A

(aka pre-icteric phase) fatigue, malaise, anorexia

41
Q

HBcAg

A

****HBV core antigen****

42
Q

what is the infectious cause of primary hepatocellular carcinoma

A

HBV!!! ******* this was mentioned twice! 80% of hepatocellular carcinoma is linked to chronic HBV *****

43
Q

anti-HBs

indicates

A

vaccine

or

resolved infection

***immunity***

you’ve got nothing SIMMERING

44
Q

dane particle

A

infectious form of HBV

45
Q

what does HBV tx do?

A

antagonizes viral replication, preventing extensive liver damage… NOT A CURE

46
Q

how to prevent HAV

A

proper hand washing,

PEP early in infection (85% effective in 1st 2 weeks of exposure)

inactivated vaccine

47
Q

why would tx of HBV be contraindicated?

A

depends on there liver function and virus replication status (viral load)

48
Q

A incubation period

A

2-6 weeks

49
Q

type of HBV vaccine

A

subunit

50
Q

what antigens and antibodies are you going to see if you have someone who was vaccinated for HBV

A

antibodies to surface and surface fragment antigens:

IgG- anti HBs (anti-surface)

anti-HBe (anti-infectious surface fragments)

no antigens

51
Q

what % of people with acute HCV develop chronic

A

85%

52
Q

major reservoir for HBV

A

chronic hepatitis patients

53
Q

HBsAg (+)

total anti-HBc (+)

IgM anti-HBc (+)

anti-HBs (-)

A

acutely infected

54
Q

what equates to a poor prognosis for HCV

A

long time without detection

55
Q

what is not a good test for HCV

A

ELISA because chronic state and viremic pts often escape detection because seroconversion is slowly after 24 weeks

56
Q

the incubation period of hepatitis represents

A

a dose dependent range

57
Q

IgM

A

anti-HBc

antibodies against core antigen

indicates new, ongoing HBV infection if present with HBsAg in serum (diagnostic)

Mr. Policeman, He’s the 1st responder

58
Q

what can a pt be given for tx of HBV?

A

polyethylene glycol (PEG) interferon and or agents to inhibit the viral polymerase including nucleoside and nucleotide analogues

59
Q

HAV dx

A

IgM antibody by ELISA

60
Q

HBsAg (-)

total anti-HBc (+)

anti-HBs (+)

A

immune due to prior natural infection

61
Q

HBsAg is present in

A

active disease

S = SIMMERING

(acute or chronic)

62
Q

HBeAg

A

HBV surface antigen fragment-

presence indicates a pt is infectious *******

63
Q

NANB hepatitis

A

not A not B

90% of the time this is C

64
Q

is interferon required for chronic HCV infections

A

no- there are several tx options

65
Q

populations at risk of HBV

A

*** HEALTHCARE WORKERS and IVDUsers**** also: gays, slutty straights, institutionalized ppl, family contacts of infected

66
Q

tx for most HBV infections

A

most resolve spontaneously and do not require anti-viral tx

67
Q

which populations of HBV pts are at high risk of becoming chronic

A

perinatal and peds

68
Q

why is dx of HCV tricky

A

it often eludes immune mechanisms

69
Q

most acute HCV infections present

A

asymptomatic and are therefore not diagnosed in the acute phase

70
Q

what antibodies and antigens are you going to see if HBV progresses to chronic

A

HBsAg- surface antigen

HBeAg- surface fragments = infectious

total anti-HBC

(no IgM- anti HBc, he’s just around for the acute phase)

71
Q

risk factors for HCV

A

CONTACT WITH HEALTHCARE PROVIDERS, IVDU, dialysis, tattoos, transfusions, transplants

72
Q

in developed countries the peak of transmission of HCV occurred between what years

A

1960-1980

73
Q

B incubation period

A

2-6 months

74
Q

HDV is what type of virus

A

a viral parasite of HBV that uses HBsAg for its capsid

75
Q

type of HAV vaccine

A

inactivated virus

76
Q

with HDV often comes

A

chronic infection

77
Q

up to __ in ___ people of what age group may be infected with HCV and may begin presenting with cirrhosis and or cancer soon

A

1 in 33 baby boomers

78
Q

Type D Hepatitis

A

delta agent, ONLY in pts with active HBV infection

79
Q

icteric phase sxs

A

JAUNDICE, dark urine, hepatomegaly, high ALT and AST

80
Q

E incubation period

A

3-9 weeks

81
Q

HCV dx

A

ELISA

+

a confirmatory test (ie western blot or direct nucleic acid test)

82
Q

what is an EXTRA rapid and severe HDV outcome

A

when it co-infects with HBV in a previously uninfected individual

OBGYN microbiology (13 decks)

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