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Gastrointestinal > Viral Hepatitis > Flashcards

Flashcards in Viral Hepatitis Deck (50):
1

microbiology of Hep A

a hepatovirus; a small, unenveloped symmetrical RNA virus which shares many of the characteristics of the picornavirus family

2

prevalence of hep A is highest in? (3 continents, 1 country)

south america, africa, southeast asia, and greenland

3

how is hep A transmitted?

fecal-oral via contaminated food/water

4

how does hep A manifest?

acute illness with flu-like sx, maybe N/V/D, icterus/jaundice

5

HAV IgM indicates?

acute exposure to hep A

6

HAV IgG indicates?

prior exposure OR vaccination

7

treatment of hep A

supportive, usually mild

8

close contacts to a pt with acute exposure to hep A should?

receive hep A immune globulin and vaccination

9

microbiology of Hep B

a member of the hepadnavirus group, double-stranded DNA viruses which replicate, unusually, by reverse transcription

10

prevalence of hep B is highest in?

southeast asia, africa, japan, northern canada and alaska

11

how is hep B transmitted?

parenteral, sexual, or perinatal contact

12

of those exposed to hep B, what % develop chronic HBV? Fulminant?

1%, 4%

13

what does it mean if a pt is positive for the HB surface antigen, and what test must be done next?

they are infected with HBV; the next test is for IgM anti-HBc to determine if it is acute (IgM+) or chronic (IgM-)

14

a person who has received the Hep B vaccine will be negative for all tests except?

antibody to HB surface antigen (HBsAb)

15

positivity to HBcAb and HBsAb implies?

immunity due to natural infection that has been fought off

16

a patient with all negative tests except for HBcAb (anti-HBc+) has?

one of several options: 1) resolved infection, 2) false+, so needs vaccine, 3) "low-level" chronic infxn, or 4) resolving acute infxn (in the window)

17

what is the most common form of HBV transmission in the West? In high prevalence areas (Asia/Africa)?

sexual/parenteral in the West; vertical in Asia, Africa

18

HBV immune tolerance occurs in ______-acquired HBV, manifests with (high/low) viral replication, (+/-) for HBeAg, and (+/-) for liver dz sx

perinatally; high viral replication; HbeAg+; no sx of liver dz (nl ALT)

19

during their 20s or 30s, patient with perinatally acquired HBV progress to the _________ stage, in which they are positive on which HBV tests? What is their ALT level?

immune clearance stage; positive for HBeAg, anti-HBe and sometimes anti-HBc (IgM); ALT spikes

20

inactive carriers of HBV show what lab results? Biopsy results?

low levels of DNA and ALT; HBeAg NEGATIVE, but anti-HBe positive; liver biopsy may show active dz

21

the "pre-core mutant" is?

an HBeAg negative form of chronic hepatitis where the patient has developed an alternate form of the virus that does not produce HBeAg (the patient has anti-HBe but no HBeAg)

22

resolution of chronic HBV infection is (common/rare) and patients who resolve HBV still have ______ even after clearance (risk of reactivation in immunosuppressed)

rare; cccDNA

23

hep D is tranmitted by?

parenteral or sexual

24

hep D is a ____ virus that is only seen in the setting of __________

delta (defective RNA virus); chronic hep B

25

how is hep D dependent on hep B?

requirs HB surface antigen to replicate

26

where is hep D endemic?

Mediterranean area

27

HDV is most likely in a patient with progressive liver dz and _____ hep B DNA

inactive/suppressed

28

microbiology of hep C

enveloped single-stranded RNA virus with 6 major genotypes

29

HCV is transmitted?

parenterally (sexual transmission very rare)

30

HCV is of particularly high prevalence in?

the middle east, Egypt

31

HCV is of intermediate prevalence in?

eastern europe, mediterranean, south america, asia

32

HCV is (more/less) likely to result in chronic hepatitis than HBV

more

33

which HBC serotype is most common in the US? Which is most difficult to treat?

GT 1; GT 1

34

which genotype is found in Egypt and the Middle East?

GT 4

35

the majority of patients infected with HIV (resolve infx/get chronic HCV)

chronic HCV (85%)

36

the majority of patients with chronic HIV (become stable/develop cirrhosis)

become stable (80%)

37

the majority of patients with HCV cirrhosis (are stable/die)

stable (75%)

38

HCV is the leading indication for what procedure?

liver transplant

39

the majority of patients with chronic HCV have what symptoms?

none or fatigue, nonspecific complaints

40

if a screening exam shows a high ALT, what HCV test should be performed?

anti-HCV

41

if a patient is positive for anti-HCV, what test should be performed next?

HCV RNA to determine whether the infection is present or cleared

42

factors promoting progression or severity of HCV infection

alcohol intake, steatosis, age > 40, HIV or chronic HBV co-infection, male gender

43

common extrahepatic manifestations of HCV

arthralgia, skin manifestations, HTN, sicca syndrome (mouth, eyes)

44

hepatitis E is most similar to what other hepatitis?

hep A

45

hep E is (acute/chronic), icteric, and self-limiting

acute

46

how is hep E transmitted?

fecal-oral via contaminated water

47

is there a strong case for animal to human transmission of HEV?

NO

48

how long is the incubation period for HEV, and what causes damage to the liver?

2-10 weeks; immune-mediated rxn

49

clinical manifestations of HEV are ____

highly varied; may cause icterus

50

HCV illness in _____ is milder, but in _____ can be fatal

children; pregnant women