What are other causes of hepatitis besides hepatitis viruses?
EBV and CMV
Which type of bilirubin is increased in hepatitis?
both CB and UCB
How do you distinguish acute from chronic viral hepatitis?
chronic - symptoms last > 6 months
What is the appearance of the liver in acute hepatitis?
lobular disarray, liver cell death
central phelbitis, endophlebitis
What are councilman bodies
pyknotic nucleus extruded from liver cells
Chronic hepatitis presents with a sepctrum of inflammation, name some types of these pathologies?
- focal periportal necrosis
- portal tract lesions - proliferation of bile ductules
- intralobular lesions
- periportal fibrosis
What is confluent hepatitis necrosis
death of hepatocytes in geographical distribution
affects whole regions of lobule
What is the most common cause of confluent hepatitis necrosis?
What is the method of transmission of each of the hepatitis viruses?
hep A and E - fecal oral
Hep B, C - parenteral
Which hepatitis virus is most common?
What are some prototypical types of people that acquire hep A?
travelers, MSM, day care children
What is the main source from which people contract hep E
contaminated water (uncercooked seafood)
What type of immunoglobulin indicates active infection?
What is the first serologic marker to rise in Hep B?
What defines the chronic state of HepB?
HbsAg present for >6 months
When is the core antibody present?
acute battle and window phase
What is the sign of victory of beating hep B?
What does the presence of the envelop antigen indicate? when is it present?
present during acute phase and can be present chronically
What is the hep B vaccine composed of?
What are some extrahepatic manifestations of the hep B virus?
Ab-ag complex causes: serum sickness polyarteritis glomerulonephritis cryoglobulinemia
How do you confirm infection with hep C? how long would you need to wait
HCV RNA test
-can be detected within 2 weeks
What indicates hep C recovery?
dec RNA levels
What are some extrahepatic manifestations with hep c?
- mixed cryoglobulinemia –> systemic vasculitis
- membranoproliferative GN
- B cell non hodkin lymphomas
What is the most common indication for a liver transplantation?
infection with hep C
Hep D needs Hep B to infect, is superinfection or coinfection a more severe infection?