Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI/Hepatic Final > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

(91 cards)

Start Studying
1
Q

What are the acute forms of hepatitis?

A

A and E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the acute and chronic forms of hepatitis?

A

B, C, and D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the only way that Hep D can occur?

A

In patients that also have hep B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the s/sx of hepatitis?

A 
Often asymptomatic
N/V
Splenomegaly
Elevated liver enzymes
Weight loss
Fatigue
Fever
Jaundice
RUQ pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the route of transmission of Hep A?

A

Oral-Fecal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the RFs of Hep A

A

Area w/poor sanitation
Poor hygenic practices
IV drug use
Homosexual activity in men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Is there a chronic form of Hep A?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the prevention for Hep A in at risk children and adults?

A

Havrix
Vaqta
Twinrix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is twinrix?

A

Combo HAV and HBV vaccine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is there IgG available for pre- and post-exposure prophylaxis for Hep A?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the diagnostic criteria for Hep A?

A

HAV IgM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the outcome of Hep A?

A

Rarely fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the route of transmission for Hep B?

A

Blood

Bodily secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the RFs for Hep B?

A

IVDU
Sexual activity
Occupational exposure to infected blood or bodily secretions
Uterine exposure to infected female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is there a chronic form of HBV?

A

Yes 10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Who gets screened for HBV?

A

Patients w/RF
Pregnant females
Pts with HCV or HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the prevention for at risk children and adults for HBV?

A

Energix-B
Recombivax HB
Twinrix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Is IgG available for pre- and post-exposure prophylaxis of HBV?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the diagnostic criteria for HBV?

A

HBsAg
HBcAb
HBeAg
HBV DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the outcome of HBV?

A

Hepatocellular carcinoma or cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the route of transmission for Hep C?

A

Blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the RFs for Hep C?

A

IVDU
Blood transfusion prior to 1992
Intranasal drug users who share paraphernalia
Tattoos or body piercings if performed without proper infection control practices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Is there a chronic form of Hep C?

A

Yes (80%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the screening for Hep C?

A 
Illicit drug use
Blood transfusion prior to 1992
Blood clotting factors prior to 1987
Unexplained elevated liver enzymes
Organ transplant
Children born into HCV infected mothers
Occupational exposure to HCV infected blood or needle stick
In 2012, CDC and USPSTF recommended a 1x screen for all baby boomers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Is there prevention for at risk children and adults with HepC?
no
26
Is IgG available for pre- and post-exposure prophylaxis?
No
27
What are the diagnostic criteria for HepC?
HCV RNA | Anti-HCV
28
What are the outcomes of HCV?
Cirrhosis | Cancer (less common)
29
What is HBsAg?
Hepatitis B surface antigen Surface protein of the HBV that is used as a marker to detect infection. If this blood test is positive, then the HBV is present
30
What is HBsAb or anti-HBs?
Hepatitis B surface antibody The antibody formed in response to the surface protein of the Hep B virus. It can be produced in response to vaccination or recovery from an actual hep B infection. If this test is positive, then the immune system has successfully developed a protective antibody against the HBV that provides long-ter immunity
31
What is HBcAb or anti-HBc?
Hepatitis B Antibody The antibody only refers to a part of the virus itself; it does not provide any protection or immunity against HBV. This test is often used by blood banks to screen blood donations. A positive test indicated a person may have been exposed to the HBV, but the result can only be confirmed in relationship to the above two tests
32
What is HBeAg?
Hepatitis B e Antigen A marker of a high degree of HBV infectivity, it correlates with a high level of HBV replication. It is primarily used to help determine the clinical management of patients with chronic HBV infection
33
What is HBV DNA?
A marker of viral replication. It correlates well with infectivity. It is used to assess and monitor the treatment of patients with chronic HBV infection
34
What are drugs for HBV?
Pegylated interferon Nucleos(t)ide Reverse Transcriptase Inhibitors First line agents Other agents
35
What are the first line agents for HBV?
Entecavir | TNF/TNF-alafenamide
36
How are TNF and TNF-alafenamide related?
TNF-alafenamide is a pro-drug of TNF and has less SE related to the kidneys and bone TNF-alafenamide is shown to be non-inferior
37
What are the other agents for HBV?
Not first line d/t higher incidence of resistance Lamuvidine - oldest agent (used to be gold standard) Adefovir Telbivudine Emtricitabine - unlabeled use in HBV with co-existent HIV infection
38
What is the MOA for pegylated interferon?
Proteins produced by nucleated cells that when activated have antiviral, antiproliferative, and immune-regulating activity
39
What are the types of pegylated interferon?
``` Interferon alfa-2 (Intron A) Peg-interferon alfa-2a (pegasys) Immune modulator (helps suppress virus) ```
40
What is the MOA of NRTIs
Inhibits HBV DNA polymerase resulting in inhibition of HBV viral replication
41
When do you not used pegylated interferon alfa-2a?
Pts w/: Cirrhosis Post-transplant Co-infection with HCV/HIV
42
What are the NRTIs?
``` Lamivudine Adefovir Telbivudine Entecavir TNF TNF-alaf ```
43
How should NRTI use be monitored?
Monitor renal function prior to and during treatment
44
How are NRTI's used in an HIV co-infected individual?
Use in combo therapy with TNF/emtricitabine (Truvada) as part of HAART Never use Lamivudine, TNF, or emtricitabine monotherapy unless the pt's HIV status is determined to be negative first
45
What are the combination NRTI therapies?
Not warranted if patient is NRTI naive | Might be beneficial in patients w/cirrhosis or in patients w/pre-existing resistance
46
What combination therapies are not recommended?
peg INF and NRTI | Sequential NRTI therapy
47
What does chronic HBV treatment depend on?
HBeAg (+) or (-) HBV DNA level ALT level Disease stage/grade
48
What are the goals of chronic HBV therapy?
Prevent cirrhosis and hepatocellular carcinoma Normalization of ALT Improved histology on biopsy Undetectable HBV DNA and loss of HBeAg
49
What are the levels in a patient with a partial response to HBV therapy?
60-2000 IU/mL
50
What are the levels in a patient with no response to HBV treatment?
> 2000 IU/mL
51
Which NRTIs have low resistance?
Entecavir TNF TNF alaf
52
Which NRTI do you switch to if there is resistance?
TNF | TNF alaf
53
Which NRTI do you switch to if there is resistance to TNF or TNF alaf?
Switch to or add entecavir
54
What do you do with NRTIs if there is multi-drug resistance?
Switch to entecavir plus either TNF or TNF-alaf
55
What is peg-interferon alfa-2a's duration of therapy in HBV?
48 weeks
56
What is NRTIs duration of therapy in HBV?
Years to life long For HBeAg-positive pts: 6 months after HBeAg seroconversion and an undetectable HBV viral load For HBeAg-negative pts: treatment should be continued until HBsAg clearance
57
What are peg-inf ADRs?
``` Flu-like syndrome Myalgia HA Fatigue Weight loss Depression Hair loss Injection site rxn ```
58
What are the NRTI ADRs?
``` Generally well tolerated GI (N/V) HA Fatigue Rash ```
59
What are the NRTI BBWs?
Severe, acute exacerbation of hep B may occur upon D/c | Lactic acidosis and severe hepatomegaly
60
What are the monitoring parameters for HBV?
``` HBV DNA HBsAg HBsAb HBeAg HBeAb CBC Chem-23 (includes LFTs) ```
61
What are the medications for Hep C?
Ribavirin | Direct Acting Antivirals (DAAs)
62
What is the MOA for Ribavirin?
Inhibits viral protein synthesis and the viral replication of RNA and DNA viruses
63
What are the Brands of Ribavirin?
``` Copegus Ribaspheres Rebetol Moderiba Virazole ```
64
What are the types of DAAs?
NS3/4A Protease inhibitors NS5B Polymerase inhibitors NS5A inhibitor
65
What is the MOA of NS3/4A protease inhibitors?
Inhibits replication of the hepC virus by reversibly binding to NS3 serine protease
66
What is the MOA of NS5B polymerase inhibitors
Inhibits HCV replication by binding to the NS5B RNA polymerase
67
What is the MOA of NS5A inhibitor?
Inhibits the HCV NS5A protein necessary for viral replication
68
What is olysio comprised of?
Simeprivir (NS3/4A) | Genotype 1
69
What is technivie comprised of?
Ombitasvir (NS5A) Paritaprevir (NS3/4A) Ritonavir (Cyp450 inhibitor) Genotype 4
70
What is the viekira pak comprised of?
Paritaprevir (NS3/4A) Ombitasvir (NS5A) Dasabuvir (NS5B) Genotype 1a (or unknown genotype 1)
71
What is zepatier comprised of?
Elbasvir (NS5A) Grazoprevir (NS3/4A) Genotype 1 or 4 (use with ribavirin)
72
What is sovaldi comprised of?
Sofosbuvir (NS5B) | Genotypes 1,2,3,4
73
What is harvoni comprised of?
Sofosbuvir (NS5B) Ledipasvir (NS5A) Genotype 1,2,3,4
74
What is daklinza comprised of?
Daclatasvir (NS5A) | Genotype 1,2,3
75
What is epclusa comprised of?
Sofosbuvir (NS5B) Velpatasvir Genotype 1,2,3,4,5,6
76
What is mavyret comprised of?
Pibrentasvir (NS5A) Glecaprevir (NS3/4A) Genotype 1,2,3,4,5,6
77
What os vosevi comprised of?
Sofosbuvir (NS5B) Voxilaprevir (NS3/4A) Genotype 1,2,3,4,5,6
78
What are the BBWs for ALL DAAs for HCV?
HBV reactivation has been reported in HCV/HBV co-infected patients who were receiving or had completed treatment with HCV direct-acting antivirals and were not receiving HBV antiviral therapy
79
When do we treat chronic HCV?
All patients should be treated when diagnosed. But where resources are limited, the guidelines provide guidance on how to prioritize who to treat
80
What are the different categories of treatment for HCV
Treatment naive/relapse - w/o cirrhosis - with compensated cirrhosis
81
Special situations for treatment of HCV
Decompensated cirrhosis Patients post-liver transplant Renal impairment HIV/HCV
82
Monitoring of chronic HCV
``` HCV RNA Hepatic function panel CBC INR TSH - only if using peg-interferon ```
83
When will NS5A inhibitors interact with PPIs?
BID (HD) PPIs
84
When do we DC therapy for chronic HCV d/t lack of efficacy?
If HCV RNA is detectable at week 4, then check against it at week 6. If the HCV RNA level is > 10-fold at week 6, then DC treatment. Otherwise continue treatment
85
When is baseline resistance testing recommended?
``` HCV genotype 1a infection (with compensated cirrhosis) being considered for treatment with simeprevir or sofosbuvir Elbasvir treatment (initial treatment/retreatment) (test for NS5A resistant variants) Resistance testing during and after treatment is not recommended ```
86
What is the goal of HCV treatment
Sustained Virologic Response (SVR) - HCV RNA is not detected 12 weeks after treatment is complete
87
What are the ADRs of ribavirin?
``` Preg Cat X Fatigue Rash Hemolytic anemia HA Nausea ```
88
What are the ADRs for DAAs?
HA N/V/D Fatigue Anemia
89
What must men and women do to treat SE of HCV therapy?
Use birth control up to 6 months after completion of ribavirin
90
What is the role of statins in chronic HCV/HBV therapy?
Have been shown to reduce the risk of hepatocellular carcinoma (HCC) and cirrhosis in patients with chronic HBV/HCV
91
What is the MOA of statins in HBV/HCV?
Improve hepatic sinusoidal endothelial dysfunction, increase hepatic NO production, and decrease hepatic vascular resistance

GI/Hepatic Final (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions