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Host And Defense - Exam 3 > Quiz 7 - Spivak, A - Hepatitis > Flashcards

Quiz 7 - Spivak, A - Hepatitis Flashcards

1
Q

What is acute hepatitis?

A

Incubation = several wks

Flu-like symptoms

  • Fever
  • Myalgias
  • Pharyngitis

Jaundice
-Painful liver

Elevation in Liver Fx Test (LFT)

Resolves on its own

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2
Q

Which types of Hepatitis cause acute hepatitis?

A

A

B

E

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3
Q

Which types of hepatitis cause chronic hepatitis?

A

B

C

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4
Q

What is chronic hepatitis?

A

Often asymptomatic

Portal hypertension or liver inflammation

LFTs can be normal or elevated

Persists for years or decades

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5
Q

Tell me about Hep A.

A

Non-enveloped ssRNA virus

Fecal-oral route

Very common in developing countries
-Incidence is 100% among children

*Foodbourne outbreaks are common

Overcrowding
Poor sanitation
Polluted water sources

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6
Q

T/F - Hep A is the MOST COMMON cause of acute hepatitis.

A

TRUE

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7
Q

Tell me some clinical presentations of Hep A.

A

Most adults symptomatic, but 70% of children are asymptomatic

Risk factors

  • None
  • Day care
  • Travel
  • MSM
  • IV drug use

Mostly a self-limited illness, but some rare complications:

  • Coagulopathy
  • Encephalopathy
  • Renal failure
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8
Q

Tell me about the Hep A vaccine.

A

First dose and then second dose 6-12 months later

Hep A Ig is available for immediate passive immunity

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9
Q

When does a Hep A vaccine happen?

A

Children at 1 yo

Everyone needs to be vaccinated

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10
Q

Hep E is what type of virus?

A

Non-enveloped ssRNA virus

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11
Q

Tell me about Hep E.

A

Causes acute hepatitis that is not different from Hep A

Fecal-oral

Person-person spread is RARE

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12
Q

Tell me about the Hep B virus.

A

Enveloped DNA virus
-Partially dsDNA/ssDNA

SMALLEST KNOWN HUMAN DNA VIRUS

Compact, overlapping reading frames

All infants at birth should be vaccinated

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13
Q

What is the most common transmission of Hep B in low-prevalence areas?

A

Sexual

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14
Q

What mode of Hep B transmission dominates in high prevalence areas?

A

Perinatal
-From mom
—90% of children get Hep B from their Hep B infected mother

However, if they are then given the Hep B vaccine, they are cured in 95% of these children

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15
Q

What is the most commonly transmitted blood-borne virus in the health care setting?

A

Hep B
-B>C>HIV
—Common among IV drug-use

Parenteral (Needle stick)

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16
Q

HIV vs Hep C vs Hep B needle stick.

A

HIV - 0.3% of clinicians get HIV

Hep C - 3% of clinicians get Hep C

Hep B - 30% of clinicians get Hep B

17
Q

What factors influence chronic Hep B disease?

A

Viral replication

Host immune response

Sex
-Men more likely to develop cirrhosis

Alcohol consumption

Viral co-infection (other viruses)

*Broad spectrum from asymptomatic to chronic hepatitis to cirrhosis

18
Q

What is the most feared outcome of chronic Hep B?

A 
Hepatocellular carcinoma (HCC)
-associated with cirrhosis
19
Q

What is cirrhosis?

A

Scarred liver

20
Q

Hep B dx?

A
  • Hep B surface antigen (HBsAg) and antibody
  • Meaning your body as not cleared surface antigen via antibodies*

-Hep B core antigen and antibody
—Tells us that infection was present

  • Hep B virus e antigen and antibody
  • Hep B virus serum DNA PCR
21
Q

Tx of Hep B?

A

2 types of antivirals
-IFN and nucleoside analogs

Treat when blood says infection AND disease symptoms are present

*1st line defense meds: TENOFOVIR (6 months) and ENTECAVIR (this one is taken when pt also has HIV and is on for life)

22
Q

Tell me about Hep D.

A

Defective ssRNA virus

Passenger virus accompanying Hep B virus

  • ONLY LIVES WITH Hep B
  • It needs its machinery to replicate
23
Q

Who is at great risk for a major Hep D infection?

A

Pt that has chronic Hep B infection

24
Q

How to treat against Hep D?

A

VACCINATE AGAINST HEP B

  • IFNalpha is only approved tx
  • Low success rate
25
Q

Tell me about Hep C.

A

Enveloped RNA virus

Blood borne

  • Blood
  • IV
  • Needle sticks
  • Sex

Leads to chronic hepatitis (60-80%)

Long term risk of cirrhosis and HCC

26
Q

Hep C dx?

A

2 tests:

  • Antibody immunoassay
  • Molecular testing for presence of Hep C virus RNA
27
Q

Who should be tested for Hep C?

A

Everyone born b/t 1945 and 1965

IV drug use

Transfusion recipients (prior to 1992)

Pts on hemodialysis

HIV infected

Pts w/ liver disease

Children of Hep C+ mothers

28
Q

T/F - When testing for Hep C, always test for HIV and Hep B

A

TRUE

29
Q

Hep C management.

A

Pegylated IFN

Ribvirin

Always test for HIV and Hep B

Determine genotype for drug selection

Evaluate for liver damage and cirrhosis

If absence of viral RNA 12 weeks after tx, then 97-100% chance of cure

**Goal of tx is to reduce Hep C amount in blood to undetectable levels
—This leads to cure

Treat for CURE

Host And Defense - Exam 3 (15 decks)

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