viral hepatitis

Question 1

What is the definition of hepatitis?

Answer 1

Inflammation of the liver; acute if < 6 months, chronic if > 6 months.

Question 2

What are the 5 viruses that cause acute viral hepatitis?

Answer 2

HAV, HBV, HCV, HDV, HEV.

Question 3

What are the modes of transmission for HBV, HCV, and HDV?

Answer 3

Blood borne - percutaneous and permucosal exposure.

Question 4

What are the symptoms of acute viral hepatitis?

Answer 4

Fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, jaundice, dark urine, clay-colored stool, joint pain.

Question 5

What virus causes Hepatitis A?

Answer 5

HAV - a picornavirus, formerly enterovirus type 72, now heparnavirus.

Question 6

What is the incubation period for Hepatitis A?

Answer 6

15–35 days (median: 1 month).

Question 7

How is Hepatitis A transmitted?

Answer 7

Fecal-oral route, common source outbreaks, rarely blood transfusion.

Question 8

What is the case fatality rate of HAV?

Answer 8

0.3%; increases to 2% in patients >40 years old.

Question 9

How is Hepatitis A diagnosed?

Answer 9

Anti-IgM (5–10 days before symptoms), Anti-IgG (lifelong immunity).

Question 10

What are prevention methods for Hepatitis A?

Answer 10

Good hygiene, sanitation, HAV vaccine (IM, 3 doses: 0, 1, 6 months), passive immunization (IG).

Question 11

What is the genetic material of Hepatitis B virus?

Answer 11

Double-stranded DNA.

Question 12

What are the main transmission routes for HBV?

Answer 12

Blood, body fluids, sexual, perinatal, needles, razors, dialysis, tattoos.

Question 13

What is the hallmark of HBV infection?

Answer 13

Positive HBsAg.

Question 14

What indicates recovery from HBV infection?

Answer 14

Presence of anti-HBs.

Question 15

What does anti-HBc IgM indicate?

Answer 15

Acute HBV infection.

Question 16

What is the treatment for chronic HBV?

Answer 16

Antivirals: entecavir, tenofovir, pegylated interferon, etc.

Question 17

What percentage of HBV infections become chronic?

Answer 17

About 5% in healthy adults.

Question 18

What are some extrahepatic manifestations of HBV?

Answer 18

Membranous glomerulonephritis, polyarteritis nodosa, arthritis, skin conditions.

Question 19

What type of virus is HCV?

Answer 19

Single-stranded, positive-sense RNA virus from Flavivirus family.

Question 20

What percentage of HCV infections become chronic?

Answer 20

60–85%.

Question 21

What are main modes of HCV transmission?

Answer 21

Blood transfusion, IV drug use, needle stick, vertical transmission (rare).

Question 22

What are extrahepatic manifestations of HCV?

Answer 22

Cryoglobulinemia, thyroiditis, glomerulonephritis, lichen planus.

Question 23

What is the goal of HCV treatment?

Answer 23

Virologic cure using direct-acting antivirals (DAAs).

Question 24

What type of virus is HDV?

Answer 24

Defective virus with circular single-strand RNA that requires HBV for replication.

Question 25

What is the relationship between HDV and HBV?

Answer 25

HDV replication depends on the presence of HBV; co-infection or superinfection increases severity.

Question 26

What is the mortality rate in HDV superinfection in chronic HBV cases?

Answer 26

Can exceed 20%.

Question 27

What type of virus is HEV?

Answer 27

Single-stranded, positive-sense RNA virus from calicivirus family.

Question 28

What is the incubation period for HEV?

Answer 28

Average 40 days (range 15–60 days).

Question 29

What is the case fatality rate for HEV in pregnant women?

Answer 29

10–20%.

Question 30

Does HEV cause chronic hepatitis?

Answer 30

No, chronic sequelae are not identified.

Question 31

What is the main route of transmission for HEV?

Answer 31

Fecal-oral route.

Question 32

When do HEV outbreaks typically occur?

Answer 32

Summer and autumn.

Question 33

What are sources of infection for HAV and HEV?

Answer 33

Feces from patients with acute or subclinical infection.

Question 34

What are sources of infection for HBV, HCV, and HDV?

Answer 34

Blood and blood-derived body fluids from acute or chronic cases and carriers.

Question 35

What is the mode of transmission for HAV and HEV?

Answer 35

Fecal-oral.

Question 36

What is the mode of transmission for HBV, HCV, HDV?

Answer 36

Percutaneous and permucosal.

Question 37

Which types of hepatitis can become chronic?

Answer 37

Hepatitis B, C, and D.

Question 38

Which types of hepatitis have vaccines available?

Answer 38

Hepatitis A and B (and indirectly for D via B vaccination).

Question 39

What laboratory values increase in hepatitis?

Answer 39

ALT, AST, ALP, Ig, bilirubin, urobilinogen.

Question 40

What happens to albumin in chronic hepatitis?

Answer 40

Albumin decreases.

Question 41

What is the A/G ratio in chronic hepatitis?

Answer 41

Decreased.

Question 42

What liver enzymes are mainly present in hepatocytes?

Answer 42

ALT and AST.

Question 43

What liver enzymes are mainly present in bile ducts?

Answer 43

ALP and GGT.

Question 44

How can we determine the cause of jaundice?

Answer 44

By measuring total, conjugated, and unconjugated bilirubin levels.

Question 45

What diagnostic tools are used for liver assessment?

Answer 45

Liver function tests, ultrasound, liver biopsy, blood and urine tests.