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Flashcards in Liver 2 - viral hep Deck (26):
1

3 things that can be happening in hepatitis

immune reaction to try to eradicate
1. new infection
2. drug induced liver injury
3. autoimmune

2

which heps are always eradicated and which might go chroins

acute- A,E
chronic - BCD

3

what is type, route, chronicity, and prevantion of AnddE

type: RNA
route: fecal oral
chronic: no
prevention: clean water

4

how does transmission pattern of Aand E vary by endemics

high - person-person - uncommon outbreaks because peole immune
moderate - person-person - outbreaks common
very low - travelers, outbreaks uncommon

5

how does ALT compare to Sx

similar levels becasue represents acute inflammation

6

how does jaundice vary by age

older people tend to get it more

7

2 complications of AE

1. fulminant hep - acute liver failure
2. cholestatic or relapsing

8

mgmt of A,e

- supportive
- recover in month
- immunize household contacts

9

mech in chronic hep

immune rxn fails to eradicate and get a downreguated immunity
- over time fibrosis repaces hepatocytes

10

3 possible causes of chronic

1. viral BCD
2. drug
3. autoimmune

11

4 characteristics of chronic inflammation

1. portal inlammation
2. interface inflammation
3. parenchyma=l inflammation
4. fibrosis

12

steps of fibrosis

1. periportal parenchyma > enlarged portal tracts
2. portal-portal fibrous septa
3. portal central fibrous bridges

13

classification of hep c

0 - no scar
1 - minimal scarring
2 - scarring extends into liver containing blood vessels
3. bridging fibrosis
4 cirrosis or advanced scarring

14

what is type, route, chronicity, and prevantion of B and
D (only with B)

type: B- DNA, D RNA
route: blood
chronic: yes
prevention: harm reduction - B - vaccine

15

how does age affect chronicity of BD

younger are likely to get chronic

16

most likely way to get

blood, wound, serum

17

what is special about B structure

can live outside envelope

18

what does B serology tell us

HBsAg - infection
anti-HBs - immunity (resoved or vaccine)
anti-HBc - infection (IgM - acute)
HBeAg - infectious
anti- HBe - less infectious
HBV-DNA - viral load

19

what happens in b spont recovery

able to wipe out virus

20

what happens in b chronic

dont wipe out and it bounces back

21

2 treatments - not cure

1. immune modulatory - interferon
2. viral supression -

22

groups at risk

- people in endemic areas
- IDU
- MSM
- blood/organ donor
- hemodyalisis

23

what is type, route, chronicity, and prevantion of C

type: RNA
route: blood
chronic: yes
prevention: harm reduction

24

2 main risk groups

- immigrants
- IDU

25

clinical features of C

- jaundice in 25%
- chronic infection
- cirrosis

26

good news for hep C

now curable!

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