Is Hep A ever chronic?
Hep A virus phylogeny:
SS RNA nonenveloped
Incubation period Heb A:
3-4 wks Prodrome is low grade temp, nausea, anorexia, fatigue, mylagia, malaise
LFTs in Hep A
ALT>AST before jaundice (then 500-600s) ALT is more liver specific
Steroids have what role in Hep A tx?
Virus type Heb B
DS DNA enveloped
Most common transmission Heb B
Perinatal (vagina) NOT placenta
Heb B serum markers:
Hep B surface ag Hep Be ag - responsible for virus replication Core - Hep Bc-ag and back Once HepB ag, immune
How do you tell if someone has had Hep B in the past?
Hep B CORE antiody - not part of vaccine series
Labs Hep B:
ALT>AST, in the thousands; Bili high
Chronic Hep B is a major risk factor for hepatocellular carcinoma in what cultural group?
Tx Chronic Hep B?
Antivirals ie epivir, tenofovir, adefovir, entecovir 1 per day for a year
Protect babies from Hep B vertical infection by:
immune globulin administration within 12 hours of being born
Tea-colored urine suggests?
Icteric phase Hep B infection
85% of patients with Hep C become...
Hep C is Sexual?
Not really, Hep B is sexually transmitted Hep C is blood (tattoos, IV drug use)
T/F: Most acute infections of Hep C go unnoticed.
True, 80% subclinical
Incubation Hep C:
Must test what to dx Hep C?
Hep C Ab; can't tell from AST/ALT because it's normal
Old tx Hep C?
Peg INF and ribavarin
New tx Hep c?
Sofosbuvir (genotype 1 and 2 - 12 weeks); simeprevir
Hep C what kind of virus?
RNA virus enveloped 6 main genotypes
Hep D what kind of virus?
ss RNA (defective RNA virus) expresses core antigen named HDAg (delta antigen) co-infection OR superinfection with Hep B
Labs Hep D?
Transmission Hep E?
25% chance of WHAT in pregnant women with acute Hep E?
Hep E - what kind of virus?
High lipase is most specific for:
Pancreatitis (moreso than amylase)
Metronidazole causes what rxn with alcohol?
Dx: High serum bilirubin, unconjugated; Mild jaundice Symptoms resolve with corticosteroids
Autoimmune hemolytic anemia Antibody-mediated erythrocyte destruction. Intravascular hemolysis leads to increased serum levels of unconjugated bilirubin which exceed the capacity of hepatocytes to conjugate it.
Why do some newborns develop jaundice?
Liver is still developing, cannot conjugate bilirubin fast enough
Dx: Necrotizing arteritis of medium-sized vessels that lead to pseudoaneurysm formation, renal thrombosis, inflammation and hemorrhage; A possible complication of chronic HBV infection due to circulating immune complexes
Primary biliary cirrhosis features what positive antibody test?
Infection with the liver fluke Clonorchis sinensis predisposes to what kind of cancer?