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1 STEP UW GI > UW Hepatitis B > Flashcards

UW Hepatitis B Flashcards

1
Q

what two phases HBV goes through?

A

the proliferative phase and the integrative phase

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2
Q

The entire virion and all related antigens of the episomal HBV DNA are present?

A

proliferative phase

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3
Q

What happens in proliferative phase?

A

The entire virion and all related antigens of the episomal HBV DNA are present.

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4
Q

Where are expressed HBsAg and HBcAg?

A

on the hepatocyte cell surface

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5
Q

HBsAg and HBcAg are in conjunction with what?

A

with the MHC class I molecules

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6
Q

viral HBsAg and HBcAg + MCH I –> activation of what?

A

This expression serves to activate the cytotoxic CD8+ T lymphocytes, which respond by destroying the infected hepatocytes.

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7
Q

Note that the virion itself does not have a cytopathic effect.

A

.

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8
Q

The HBV DNA is incorporated into the host genome of those hepatocytes that survived the immune response?

A

integrative phase

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9
Q

what happens in integrative phase?

A

The HBV DNA is incorporated into the host genome of those hepatocytes that survived the immune response

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10
Q

When infectivity ceases and liver damage tapers off?

A

when the antiviral antibodies appear and viral replication stops.

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11
Q

why the risk of hepatocellular carcinoma, however, remains elevated despite antibodies?

A

The risk of hepatocellular carcinoma, however, remains elevated because of the HBV DNA that has been integrated into the host genome

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12
Q

NOTE THAT THE VIRION ITSELF DOES NOT HAVE A CYTOPATHIC EFFECT.

A

.

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13
Q

HBV cytotoxic effect?

A

Hepatitis B virus has no direct cytotoxic effect.

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14
Q

How host antibody HBsAb neutralizes HBV infectivity?

A

by binding to the viral surface antigen HBsAg and preventing the antigen from interacting with hepatocyte receptors.

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15
Q

Host antibody HBsAb neutralizes HBV infectivity. relation of this neutralization to carcinoma?

A

THIS NEUTRALIZATION OCCURS BEFORE THE VIRUS ENTERS THE HEPATOCYTE, AND THEREFORE WOULD NOT BE ASSOCIATED WITH HEPATOCELLULAR DAMAGE

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16
Q

Antigen-antibody complexes in HBV infection. What manifestation?

A

Antigen-antibody complexes cause some of the early symptoms of hepatitis B virus infection (eg, arthralgias, arthritis, and urticaria) as well as some of the chronic complications (eg, immune complex glomerulonephritis, cryoglobulinemia, vasculitis).

HBV causes III type hypersensitivity.

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17
Q

Antigen-antibody complexes in HBV infection. Relation to hepatocellular damage?

A

These complexes are not responsible for hepatocellular damage.

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18
Q

Pathogenesis of autoimmune hepatitis?

A

The pathogenesis of autoimmune hepatitis (not hepatitis B infection) involves antigen mimicry with generation of self-antigen recognizing CD4+ T lymphocytes that damage hepatocytes.

19
Q

common causes of hepatic injury in the United States?

A

HBV infection

20
Q

reason of HBV infection?

A

Frequently transmitted sexually or via percutaneous inoculation (eg, intravenous drug use)

21
Q

A distinct histopathologic manifestation of chronic infection is the accumulation of what?

A

Accumulation of hepatitis B surface antigen within infected hepatocytes

22
Q

accumulation of hepatitis B surface antigen results in what appearance?

A

This results in the appearance of a finely granular, homogeneous, pale eosinophilic cytoplasm (ground-glass hepatocytes).

23
Q

how called hepatocytes that have accumulation of B surface antigens?

A

ground-glass hepatocytes.

24
Q

Other nonspecific morphologic changes in livers infected with HBV?

A

Other nonspecific morphologic changes include hepatocyte necrosis, apoptosis, steatosis, and mononuclear portal inflammation (lymphocytes, macrophages

25
Q

HBV hypersensitivity? manifestation?

A

type III. SERUM SICKNESS-LIKE.

joint pain, lymphadenopathy, and a pruritic urticarial vasculitis rash

26
Q

transmission of HBV?

A

sexually, parenterally, or vertically.

27
Q

type of HBV and incubation time?

A

Hepatitis B is a DNA virus with an incubation period of 30-180 days.

28
Q

what is elevated in HBV hepatitis?

A

aspartate aminotransferase and alanine aminotransferase, often >10 times the upper limit of normal.

29
Q

Most patients will have nonicteric hepatitis, but icteric hepatitis with jaundice and elevated bilirubin is also common.

A

.

30
Q

what impaired function of liver defines poor prognosis?

A

Impaired hepatic synthetic function, as indicated by a prolonged prothrombin time, confers a poor prognosis

31
Q

The most important early marker of acute infection?

A

hepatitis B surface antigen (HBsAg),

32
Q

when hepatitis B surface antigen (HBsAg) can be detected?

A

May be detectable prior to symptoms or changes in transaminase levels

33
Q

in accordance to HBaAg what other marker can be detected?

A

IgM anti-hepatitis B core (anti-HBc) may also be positive.

34
Q

what 2 markers correlate with infectivity?

A

Hepatitis B e antigen (HBeAg) and HBV DNA counts correlate with infectivity.

35
Q

What other clinical manifestation apart from serum sickness symptoms may be present?

A

Other features may include right upper quadrant pain, hepatomegaly, and elevated hepatic transaminase levels

36
Q

what apoptosis undergo hepatocytes?

A

hepatocytes may undergo cytotoxic T-cell-mediated apoptosis due to the presence of viral antigens on the hepatocyte surface.

37
Q

where present viral antigens?

A

hepatocytes may undergo cytotoxic T-cell-mediated apoptosis due to the presence of viral antigens on the hepatocyte surface.

38
Q

appearance of apoptotic cells?

A

round, acidophilic (pink on hematoxylin and eosin staining) bodies known as Councilman bodies.

39
Q

what are concilman bodies?

A

apoptotic cells appear as round, acidophilic (pink on hematoxylin and eosin staining) bodies known as Councilman bodies.

40
Q

how is defined inflammation in viral hepatocytes?

A

panlobular lymphocytic inflammation, which may “bridge” into adjacent hepatic lobules due to collapse of the reticulin framework.

41
Q

how looks areas of hepatocyte injury?

A

Spotty areas of hepatocyte injury are typically seen.

42
Q

appearance of necrotic hepatocytes?

A

Necrotic hepatocytes appear ballooned with pale cytoplasm (ballooning degeneration).

43
Q

location of chronic viral hepatitis inflammation?

A

significant inflammation surrounding the portal triad (hepatic artery branch, portal vein branch, bile ductule)

44
Q

appearance of hepatocytes in chronic B?

A

Hepatocytes usually have a ground-glass appearance (chronic hepatitis B virus)

1 STEP UW GI (16 decks)

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