Viral Hepatitis Flashcards by tcarlso 3

What is the definition of hepatitis?

Inflammation of the liver parenchymal tissue and hepatocytes

How well did you know this?

Not at all

Perfectly

What are the components of the portal triad?

Artery, vein and bile

How well did you know this?

Not at all

Perfectly

Where are zone three hepatocytes?

Right next to the central vein

How well did you know this?

Not at all

Perfectly

What are the general histological characteristics of hepatitis?

Collagenous deposits surrounding hepatocytes

How well did you know this?

Not at all

Perfectly

Why do we care if patients have hepatitis w/o symptoms?

Chronic inflammation can lead to cirrhosis and HCC

How well did you know this?

Not at all

Perfectly

What are the ssx of hepatitis?

Malaise
N/v
HA
Myalgias
Abdo pain

How well did you know this?

Not at all

Perfectly

What is fulminant hepatitis?

Condition where there is so much inflammation in the liver, that it fails

How well did you know this?

Not at all

Perfectly

What are the three main immune related caused of hepatitis?

Autoimmune
Primary biliary cirrhosis
Primary sclerosing cholangitis

How well did you know this?

Not at all

Perfectly

What are the three hereditary causes of hepatitis?

Wilsons
Hemochromatosis
A1ATD

How well did you know this?

Not at all

Perfectly

Which hepatitis viruses are self limited diseases?

A and E

How well did you know this?

Not at all

Perfectly

Which hepatitis strains can cause chronic disease?

BCD

How well did you know this?

Not at all

Perfectly

What are the abs that are found in autoimmune hepatitis?

ANA
ASM
LKM

How well did you know this?

Not at all

Perfectly

What is the treatment for autoimmune hepatitis?

Steroids or immunomodulators

How well did you know this?

Not at all

Perfectly

What are LFTs like in autoimmune hepatitis?

Increased ALT/AST

How well did you know this?

Not at all

Perfectly

In which gender more commonly has autoimmune causes of hepatitis?

Women

How well did you know this?

Not at all

Perfectly

What is the classic histological characteristic of autoimmune hepatitis?

Portal triad inflammation

How well did you know this?

Not at all

Perfectly

What are the ssx of autoimmune hepatitis?

Asymptomatic, until cirrhosis overwhelms the liver

How well did you know this?

Not at all

Perfectly

What is primary biliary cirrhosis? Which antibody is elevated in this disease?

Immune mediated destruction of the bile canaliculi

AMA (80% sensitive)

How well did you know this?

Not at all

Perfectly

What happens to cholesterol in primary biliary cirrhosis?

Increases

How well did you know this?

Not at all

Perfectly

Which disease has an increased chance of developing with primary biliary cirrhosis?

Osteoporosis

How well did you know this?

Not at all

Perfectly

What is the treatment for primary biliary cirrhosis?

Urso (bile acid supplement)

How well did you know this?

Not at all

Perfectly

What is primary sclerosing cholangitis? What is the antibody that is elevated in this disease?

Immune mediated stricturing of the biliary tree (macroscopically), that can involve intra and extrahepatic duct systems

ANCA+

How well did you know this?

Not at all

Perfectly

What IBD is associated with primary sclerosing cholangitis?

How well did you know this?

Not at all

Perfectly

What is the treatment for primary sclerosing cholangitis?

None

How well did you know this?

Not at all

Perfectly

How fast does primary sclerosing cholangitis progress?

decades

What are the viral infections of the liver besides classic hepatitis viruses? (6)

``` CMV Herpes EBV Yellow fever Adenovirus HIV ```

What are the parasitic infections that can cause hepatitis?

Toxoplasmosis Leptospirosis Q fever Rocky mountain spotted fever

What is the cause of Q fever?

Coxiella burnetii

What two abx can cause hepatitis?

Amox | Nitrofurantoin (macrobid)

What antiarrhythmic can cause hepatitis?

Amiodarone

What antineoplastic agent can cause hepatitis?

Methotrexate

What anesthetic gas can cause hepatitis?

Halothane

What drug requires that you follow the patient for hepatitis?

INH

What are the four toxin-induced hepatitis causes?

Tylenol Amanita phalloides White phosphorus Carbon tetrachloride

What is the death cap mushroom? MOA?

Amanita Phalloides | Alpha-amantin inhibits RNA pol II

What is the use of CCl4?

Refrigerant/cleaning

What are the diseases that can cause hepatitis secondarily?

``` SLE Scelorderma Sjogrens UC/CD Hemolytic anemia Glomerulonephritis ```

What is the viral family and genetic makeup of hep A? Is it enveloped?

Picornaviridae +ssRNA Non-enveloped

When does ALT rise in hep A infection?

Early, then drops down in a few months

What happens to IgM anti-HAV throughout the course of infection?

Parabolic

What is the route of infection for Hep A?

Fecal-oral route, but also homosexual activity

What is the most common place to get Hep A infection in the US?

Day care centers

What are the three clinical variants of HAV infections?

Cholestatic hepatitis Relapsing hepatitis Fulminant hepatic failure

What are the ages that Hep A infection usually occurs in?

5-14 year old

What is the reservoir for Hep A in the US?

Children

How many doses are needed for the Hep A infection? Is this a live attenuated virus, or a killed virus?

2 doses | There is both a live-attenuated and a killed version

What is the viral family and genetic makeup of Hep B? Is it enveloped?

Hepadnaviridae dsDNA Enveloped

What is the only hepatitis virus that can integrate itself in the liver DNA and cause chronic hepatitis?

Hep B

What is the route of transmission for HBV?

Parenteral (IV drug use, sex, mucosal contacts)

What is the most common cause of hepatitis B in the world?

Transplacental (vertical) Transmission

Why is HBV endemic in africa and asia?

Vertical and horizontal transmission from mothers

What happens to the risk of developing a chronic infection from HBV as we age?

Lowers

Is the HBV vaccine live attenuated or killed? How many doses?

Contains just the surface protein | x3 doses

When do we start treating HBV infections? Why?

greater than 6 months, since most likely will resolve on its own

When does HBV infection become problematic? Why?

When it develops into a chronic infection d/t chronic inflammation

What are the serological markers for HBV?

HBsAg Anti-HBc IgM HBeAg

If a patient has a surface antigen positive for HBV, what does this indicate?

Active infection

IgM to antibody to hep B core protein indicate what?

Recent infection or "flare" of chronic HBV

What happens if there is a positive surface antibody to HBV (what does this indicate)?

Patient was immunized (never exposed)

IgG anti-HBc indicates what?

Remote infection

Isolated Anti-HBc is caused by what? (4)

Low level HBV carrier Recovered Hep B False positive Window phase

What is the treatment for HBV infection?

Interferon Lamivudine Adefovir dipivoxil

What is the only treatment that can wipe out HBV in the body?

Interferon

What is the effect of interferon on hepatocellular CA?

Lowers it

What is Lamivudine? MOA?

Orally administered nucleoside that inhibits DNA polymerase for HBV infections

What are the side effects of Lamivudine? Problems?

Negligible Huge cost, and develop resistance

Does lamivudine kill the virus?

No, just controls it

What is the MOA of adefovir?

Reverse transcriptase inhibitor of Hep B

What is the only medication for HBV infection in pregnancy?

Lamivudine

What is the viral family and genetic composition of Hep D? Enveloped?

Deltavirus -ssRNA Enveloped (with HBV envelope)

Which Hep virus required another? Which Hep virus does it need?

D needs HBsAg

What is a coinfection of Hep D?

B and D occur at the same time in an otherwise healthy individual

What is a superinfection of Hep D?

Patient with chronic Hep B infection is infected with Hep D. Causes real bad outcome

Why is Hepatitis E concerning?

causes fulminant hepatic failure in pregnant women

What is the viral family and genetic makeup of hepatitis E? Enveloped? Transmission?

Hepeviridae +ssRNA Non-enveloped Fecal-oral route

What group of animals have Hep E?

Swine pig farmers

Which hepatitis virus is the most common cause of liver transplant?

Hep C

Viral Hepatitis Flashcards

(77 cards)