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237 Cards in this Set
- Front
- Back
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Exceptions to feco-oral route of transmission |
Strongyloides and Schistosoma enter through skin
Hep B/C are blood-borne |
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Secondary conditions to H.pylori infection
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PUD
Atrophic Gastritis Gastric Adenocarcinoma Gastric Bcell lymphoma |
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Rapid onset and Resolution is characteristic of?
What Microbes? |
Food Poisoning
S.Aureus, Bacillus Cereus, C.perfringes, C.dificile |
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Secretory (watery) diarrhea is commonly caused by ____ and is usually ___-_____
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viruses
self-limited |
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Stomach/Abdominal Pain which improves after a meal with no diarrhea
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H.pylori CGastritis (PUD/DUD)
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Upper GI/N/V little diarrhea with rapid onset
microbes |
Food Poisoning
S.Aureus, Bacillus Cereus, C.perfringes, C.dificile |
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Colon/pain, Diarrhea, GROSSLY bloody stools, H+U syndrome, few or absent fecal leukocytes
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Hemorrhagic Colitis of EHEC
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Systemic illness and monocytic leukocytosis suggests
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Salmonella typhi or paratyphi
Y.enterolitica |
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Colon/**Fever, bloody mucopurulent diarrhea, abdominal cramps
**heavy to variable leukocytes Syndrome? Microbes? |
Dysentery
Campyobacter Salmonella Shigella Yersenia enterolitica Entamoeba histolytica Clostridium dificile (AB related) |
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Watery diarrhea **without leukocytes**
Syndrome? Microbes? |
Secretory Diarrhea
E.coli, ETEC EPEC EAEC, EHEC V. Cholerae Rotavirus Norovirus Giardia Lamblia Cryptosporidium |
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Characteristic presentation of Norovirus aside from Secretory Diarrhea?
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Prominent Vomiting
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most frequently identified agent of acute infectious diarrhea in US?
Vehicle? |
Campylobacter
Chicken |
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Bloody Diarrhea preceeded by a day or two of watery diarrhea
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Dysentery -
Crypt abscesses prominent |
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Humans are the only natural reservoir of what dysentery cause?
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Shigella
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Common cause of dysentery in Europe/Canada
assoc w? |
Yersenia
milk |
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______ penetrates quickly and travels to regional lymphatics
patient presents with diarrhea and **RLQ pain** Stool leukocytes? Secondaries? |
Yersenia enterocolitica
few leukocytes Mimics appendicitis Bacteremia |
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Related to AB use?
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C. difficile
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_________ is an invasive _____ which causes dysentery and liver abscess
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Entamoeba histolytica
protozoan |
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Severe abdominal cramping following by grossly bloody stools
luekocytes? most serious complications? |
EHEC
low to no leukocytes H&U, thrombotic thrombocytopenic purpura |
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How can one presumptively differentiate between invasive bacteria and noninvasive pathogens, viruses, and protozoa?
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microscopic stool examination for RBCs and Leukocytes with METHYLENE BLUE
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Tool used for diagnosis of Amebic dysentery, giardiasis, and helminth infections
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O & P
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RBCs/Leukocytes in Amebic Colitis?
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usually absent, Ameba engulf
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prolonged systemic disease without diarrhea
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Typhoid
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exclusive cohabit site of S. typhi
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Gall Bladder
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Bloody diarrhea without fever
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EHEC
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Gram negative curved rods *seagull-shaped* organisms
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Campylobacter jejuni
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Major virulence factor to C. jejuni |
flagella, allows colonization of mucosa
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Major antigen of C. jejuni
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LPS
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Growth of Campylobacter jejuni requires? Tests for?
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Selective Media
Microaerophilic 42C tests for catalase and oxidase activity |
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Most common cause of diarrhea illness in USA
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C. jejuni
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most case of C.jejuni are ____ and associated with (2)
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sporadic
improper food handling poultry |
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Site of Campylobacter infection? Reaction?
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Jejunum
acute nonspecific neutrophilic and monocytic with LP and epithelial damage |
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C. jejuni in HLA-B27 patient can lead to?
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Reactive Arthritis
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Guillain-Barre syndrome may be related to what microbe?
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Campylobacter jejuni
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DoC of Campylobacter if required?
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Erythromycin
Quinolones if elderly or complicated |
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If poultry, think
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Campylobacter
Salmonella typhimurium |
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_ antigens undergo ___ ____ in salmonella to produce multiple strains
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H
phase variation |
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Predisposition to Salmonella?
Normal infective dose? Why? |
reduced gastric acid
10^5 normally Salmonella requires large inoculate because it is acid sensitive |
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Hektoen agar showing green *nonlactose fermenting* colonies with mostly black centers due to h2s production
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Salmonella
99% are nonlactose fermenting |
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gram(-) motile noncapsulated nonlactose fermenting bacteria causing dysentery
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Salmonella
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___ and ___ mediate sepsis from Salmonella if it invades bloodstream following reticuloendothelial dissemination
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LPS and cytokines
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Why are ABs not used in salmonella? |
can result in protracted diarrhea
Immunocompromised, neonates, 50+ Fluoroquinolones |
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Second most common source of salmonella outbreaks?
Solution? |
improperly cooked eggs (bulk)
but pasteurized eggs |
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3 day history chills and high fever after bout of diarrhea following visit to India
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Typhoid
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Erythematous maculopapular lesions with systemic illness following GI disturbance
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Rose Spots of typhoid
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Hepatosplenomegaly
Leukocytosis Rose Spots |
Typhoid
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difference between S. typhi and other strains?
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encapsulated with "K/Vi" antigen
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RoT Typhoid
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FecoOral
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Where does S.typhi enter the body? |
Terminal Ileum
*Survives in macrophages* *Infiltration of macrophages into mucosa* Causes Bacteremia |
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_____ are particularly resistant to bile, reentering intestine and causing second bout of diarrhea days after febrile illness
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S typhi
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Predisposition to chronic carrier state in tyhpoid?
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biliary obstruction or gallstones
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DoC of Typhoid
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Ciprofloxacin, 10 days
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Prevention of Typhoid?
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Live attenuated vaccine
IM vaccine to Vi also available |
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tenesmus
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feeling need to evacuate even if bowels empty, straining/pain
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A rapid descending course of infection, wit fever and abdominal pain progressing to mucoid diarrhea with bloody stools (Colitis) is classic for?
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Shigella
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Dysentery with long gradual onset of 1-2 weeks of P/D/Tenesmus with fever being rare
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Entameoba histolytica
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Most common US Shigella
Most common Intl? (travelers)* Shigella which ferments lactose Most virulent? Least Severe (no mucus secreted) |
S onnei
S flexneri* S sonnei S dysenteriae S sonnei - young/elderly |
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Growth of Shigella is on?
Microbe properties? |
Hektoen
Nonlactose fermenting (excpet sonnei) Nonmotile, nonencapsulated, facultative anaerobes |
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Pathogen unique for low infective dose
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Shigella
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Dysentery with *Colonic Ulcerations and erythematous friable mucosa
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Shigella
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H&U and TTP are caused by?
mechanism? |
Shigella dysenteriae
E coli Shiga Toxin inhibits protein synthesis targetting the 23S rRNA |
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TX Shigella flexneri?
if resistant? |
Fluids + TMP/SMX
quinolones |
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Acute severe abdominal cramps
rapid change from watery to bloody BEEF |
EHEC
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bloody diarrhea without fever
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think EHEC
check E histolytica if travel |
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Growth of E coli O157:H7 on?
Results? |
MacConkey Agar
Indole+ Lactose+ *Sorbitol-nonfermenting solute* *Shiga toxin producing* |
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Locations / Foods of sporadic EHEC
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Sporadic in Northern US Canada
beef, unpast milk, cider, brussel sprouts, lettuce, salami |
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When does H&U syndrome occur? |
Following stx1/2 binding to kidney endothelial cells (shiga/ehec)
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When does TTP occur?
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destruction consumption sequestration aggregation of platelets in liver, spleen, kidney
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TX EHEC?
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none, can exacerbate Stx effects
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Attachment and effacement of EHEC?
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Brushborder
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Rice-water stools
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Cholera
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Yellow sucrose fermenting colonies of TCBS selective agar
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Cholera
Thiosulfate-citrate-bile-sucrose |
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Microbial Properties of Vibrio Cholera
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Flagellated
Gram - comma Nonspore forming Oxidase+ Facultative anaerobe **TCBS agar** |
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Which Cholera organisms cause epidemics and pandemics?
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Those which agglutinate in 0:1 antiserum
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Cause of first six Cholera Epidemics?
Cause of seventh? Where? Eighth? |
Classic 0:1
El Tore 0:1, Indonesia 0:139 Bengal, India |
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Risk factors for 0:1 Cholera?
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Contaminated food/water exposure
Achlorhydria, antacids, decreased aciditiy |
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Non-0:1 Cholera risk?
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raw shellfish in US
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Cholera relies on _____ for survival because it is not ______ _____
therefore _______ is a large risk factor |
large inoculum
acid resistant hypochlorhydria |
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TX Cholera?
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Fluids
Doxycycline |
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Rapid onset N/V/cramp
Group of people common food if + for enterotoxin A? |
S aureus
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S. aureus is resistant to high ____ concentrations
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salt
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Ham
Mayonnaise Custard 1-6 hours N/V/cramp |
S aureus
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Reheated fried rice
1-6 hours N/V/cramp |
Bacillus cereus
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Cream Sauce
8-24 hours Watery Diarrhea |
Bacillus cereus
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Reheated meats, dishes, gravy |
Clostridium Perfringes
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_____ is a cause of food poisoning borne from human origin
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S aureus
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Strictly Anaerobic *Gram+ Rod with toxin production
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Clostridium dificile
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_____ is present in 50% of neonate LIs but only 4% of adult LI
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Clostridium dificile
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Primary versus Secondary cases of C dificile? |
Primary is endogenous from AB treated patient
Secondary by spores, typically in hospital setting |
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Common ABs in C dificile infection
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Clindamycin, cephalosporins, ampicillin
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_____ of _____ causes cytolysis by glycosylation of proteins producing a erythematous and friable COLONIC mucosa
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Toxin A+B of C dificile
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DoC C dificile
2nd |
Metronidazole
Vancomycin |
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______ causes multiple elevated yellowish white plaques within the colon (+name) leading to *Toxin Megacolon
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C dificile
pseudomembranous colitis |
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70nm nonenveloped segment icosahedral dsRNA virus
**RIM/wheel appearance** |
Rotavirus
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despite having a 11 segmented dsRNA genome, ___________ plays no role in diversity of this virus
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Rotavirus
Gene re-assortment |
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Method of diagnosis for Viral Ags?
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Once eliminating possibility of other microbes, **assays**
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#1 severe dehydrating diarrhea in infants
season? transmission? |
Rotavirus
winter fecal-oral |
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Pathogenesis of Rotavirus?
Occurs in conjunction with? |
destruction of villus tips, with replacement of immature cells, results in poor absorption --> OSMOTIC diarrhea
Respiratory Tract Infections |
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Rare GI defect which can occur with rotavirus?
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Intussusception
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Vomitting with secretory diarrhea suggests?
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Viruses? Rota + Noro
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Mass group of people |
Enteric Virus
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Norovirus is what type of virus?
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27nm nonencapsulated +sense ssRNA caliciviridae
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Criteria to differentiate Norovirus from other viruses?
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1 - incubation period of 24-48 hours
2 - high levels of vomitting 3 - rapid spread of diarrhea symptoms 4 - resolution within 12-60 hours |
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What is required for visualization of Norovirus
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combination with human ABs
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Bacteria and Virus which require very low inoculums
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Shigella and Norovirus
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Pathologic features of Norovirus infection
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Shortening and atrophy of villi
Hyperplasia of crypts LP infiltration of PMN and macrophages |
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TX Norovirus
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ORAL rehydration
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Long-standing abdominal pain with improvement upon eating
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Gastric
H.pylori |
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RUQ pain
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cholecystitis
cholelithiasis |
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Curved/S-shaped organisms adjacent to gastric epithelial cells
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H.pylori
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3 Tests for H.pylori
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Fecal Ag
13C urea-breath test IgG-H.pylori |
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Stains for H.pylori?
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Giesma
Warthin-Starry |
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H.pylori micro and growth?
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Gram(-) curved rod
Urease producing Motile Growth with *Skirrow Agar*, *Microaerophilic* 37C |
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Most important risk factors for H.pylori overgrowth and chronic infection?
Major Cofactors? |
Increasing age and socioeconomic status
Excess acid, smoking, stress, spicy |
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What protects H.pylori from destruction from stomach acid?
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Cloud of Ammonia
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What is elevated in patients with CagA containing H.pylori
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Mucosal levels of IL-8
a potent chemoattractant |
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Two virulence factors of H.pylori
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VacA (vacuolating)
CagA |
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What histologically denotes Chronic Gastritis from H. pylori
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Mononuclear cell infiltration of submucosa
Erosion of superficial layer Neutrophilic infiltration of LP |
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Host response in H.pylori? Outcome?
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IgG
Ineffective because microbe can burrow in mucosa |
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TX H. pylori
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PPI 2-4weeks
Clarithromycin Amoxi or Tetra or Metro |
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Cause of duodenal ulcers?
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H.pylori
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Other name for Gastric B-cell lymphoma?
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MALT
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Extended bout of mucus-bloody diarrhea with tenesmus following an intl' trip should suggest?
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Entamoeba histolytica
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Trophozoite with ingested RBCs
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Entamoeba histolytica
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Trophozoite and Cyst formations of Entameoba histolytica?
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Trophozoite is singly nucleated and 15-20um
Cyst has four nuclei and is 12-5um |
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How can one differentiate between E.histolytica and E.dispar in LM? Why is this important
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By the presence of RBC phagocytosis
This is important because E.dispar is lumen dwelling and E.histolytica is invasive |
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Natural Reservoir of E. histolytica?
Infection occurs by? |
Humans
ingestion of cysts from food/water/fecies |
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Site of excystation of E.histolytica?
Adherence/Infiltration? |
SI
LI |
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Flask-shaped ulcers
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Entameoba histolytica
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Mechanism of damage in E histolytica? (4)
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Lysis of epithelial cells
Lysis of PMNs with cysteine proteinase release, degrades collagen and elastin Engulfment of RBCs, WBCs, mucosal cells, etc |
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Cause of Amebic colitis?
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Engulfment of cells (RBC WBC epithelial etc)
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DoC E histolytica in symptomatic patients?
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*Metronidazole*
+ iodoquinol or paromomycin or diloxanide for intraluminal infection |
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Serious systemic concern with E.histolytica?
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Irreversible Hepatocyte Destruction
(Amebic Liver Abscesses) |
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1-2 weeks |
Amebic Liver Abscess
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Prolonged diarrhea
Flatulence Foul-smelling stools Suggests? Considerations? |
Protozoal Agent
Giardia, Cryptosporidium, Cyclospora |
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Pear-shaped with convex dorsal and flat ventral surfaces
Four pairs of flagella Lives freely where? |
Giardia Trophozoite
upper small bowel lumen |
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Oval structure with four nuclei encased ina thin wall of NAG
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Giardia Cyst
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Natural Reservoir of E histolytica?
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Humans
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Who is at high risk for Giardia?
|
Travelers to endemic areas
Day Care Centers |
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What promotes excystation of Giardia?
How many trophozoites are produced? |
Stomach Acid
2 per |
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Pathogenesis of Giardia?
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Noninvasine, nontoxic
damage microvilli or brush border causing watery diarrhea |
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DoC Giardia?
Alternates? |
Metronidazole 7 days
Albendazole or paromomycin |
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Simple prevention of Giardia?
|
Boiling water
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Most common GI manifestation of AIDs?
|
Diarrhea
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Protozoan with acid-fast cysts
common cause of diarrhea in AIDs patients |
Cryptosporidium parvum
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What smear/stain is sensitive and specific to Cryptosporidium parvum?
|
Auramine-rhodamine smears
Ziehl-Neelsen staining (acid-fast) |
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Who is at increased risk of cryptosporidium infection?
|
AIDs
Bone Marrow Renal |
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Site of excystation of E.histolytica?
Adherence/Infiltration? |
SI
LI |
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Flask-shaped ulcers
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Entameoba histolytica
|
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Mechanism of damage in E histolytica? (4)
|
Lysis of epithelial cells
Lysis of PMNs with cysteine proteinase release, degrades collagen and elastin Engulfment of RBCs, WBCs, mucosal cells, etc |
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Cause of Amebic colitis?
|
Engulfment of cells (RBC WBC epithelial etc)
|
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DoC E histolytica in symptomatic patients?
|
*Metronidazole*
+ iodoquinol or paromomycin or diloxanide for intraluminal infection |
|
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Serious systemic concern with E.histolytica?
|
Irreversible Hepatocyte Destruction
(Amebic Liver Abscesses) |
|
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1-2 weeks
Fever Chills *Leukocytosis* *RUQ pain* enlarged liver |
Amebic Liver Abscess
|
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Prolonged diarrhea
Flatulence Foul-smelling stools Suggests? Considerations? |
Protozoal Agent
Giardia, Cryptosporidium, Cyclospora |
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|
Pear-shaped with convex dorsal and flat ventral surfaces
Four pairs of flagella Lives freely where? |
Giardia Trophozoite
upper small bowel lumen |
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Oval structure with four nuclei encased ina thin wall of NAG
|
Giardia Cyst
|
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Who is at risk for Giardia?
|
Travelers to endemic areas
Child Care Centers |
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Excystation of Giardia activated by?
|
Gastric Acid
|
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Pathogenesis of Giardia?
|
Destruction of brush border microvilli --> villus atrophy --> watery diarrhea
|
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DoC Giardia?
Alternate? |
Metro
Albendazole and paromomycin |
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DoC giardia + preggers?
|
Panomomycin
|
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AIDs
Several weeks watery diarrhea Weight loss (not actually diagnostic, only for PBL test #2) |
Cryptosporidium
|
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Smear + Stain for Cryptosporidium parvum?
|
Auramine-rhodamine smear
Ziehl-Neelsen Stain (acid-fast) |
|
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5um intracellular coccidian protozia
|
Cryptosporidium
|
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#1 site cryptosporidium
|
Jejunum
|
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Questions
Microbial features of H pylori? |
Gram(-) rod
Microaerophilic growth @ 37 Motile |
|
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Questions
pathogenic toxin of E. histolytica? |
Cytotoxin..
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Questions
Therapeutic for E histolytica? |
Metro + iodoquinol
|
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Questions
Toxin likely involved in pathogenesis of C dificile |
Cytotoxins
|
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Questions
Best method of sterilization for C dificle? |
Autoclaving @ 15lbs (121C) for 15 minutes
|
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Questions
21/51 people sick N/V/pain Custard |
S aureus
|
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Questions
Bloody Diarrhea Ulcers surrounded by inflamm cells Mexico |
E histolytica
|
|
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Questions
South America 2 weeks bloody diarrhea -->resolves 2 months later, fever chills pain RUQ pain |
E histolytica
|
|
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Questions
Extensive Purpuric Rash, Oliguria Bloody Diarrhea 1 week CIDER stool (-) for leukocytes no fever |
EHEC
|
|
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Questions |
Shigelle flexerni
ulceration of mucosa with overlying infiltration of PMNs |
|
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Description of colonic biopsy of S typhi?
|
focal areas of necrosis and mononuclear inflammatory cells in base of an ulcer
|
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Largest intestinal nematode parasite (roundworm) of humans?
|
Ascaris Lumbricoides
|
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What is the micro structure of Ascaris lumbricoides unfertilized eggs? |
45-75um in length
*Bumpy Coat* Infectious when larva develop inside, which requires a 30 day soil phase |
|
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Most common method of diagnosing intestinal ascariasis?
|
Eggs in the stool (Bumpy Coat)
|
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Where is Ascariasis most common?
What age group is it most common in? How is it transmitted? |
Southern tropical countries (mexico)
3-8 year olds Ingestion of infective (larval) eggs |
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Pathogenesis of Ascariasis?
|
Swallowed, hatch, invade intestine, portal, systemic, lungs, climb bronchial tree and swallowed, develop into adult worms, female produces eggs here
|
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Lung presentation of Ascariasis?
|
Loeffler Syndrome
cough, dypsnea, hemoptysis, eosinophilic pneumonitits |
|
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Treatment of Ascariasis?
|
Mebendazole
|
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What is the patient presentation of Ascariasis lumbricoides?
|
Nematode
Young Child No Bowel Movements 2 days 3 week HX N/pain/poor appetite Recent move/trip from Mexico Eosinophilia |
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What is the patient presentation of Strongyloides stercoralis?
|
Recent trip to humid tropical region
3 weeks worsening N/P/F 2 weeks ITCHY RASH BUTTOCKS erythematous maculopapular 15lb weight loss SIGNIFICANT EOSINOPHILIA |
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Where does the adult female strongyloid live?
|
Duodenum
Jejunum |
|
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Which microbe has the unique ability to replicate in the human host and produce infective larvae, causing reinfection?
|
Strongyloides stercoralis
|
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What does an O&P reveal in S.stercoralis?
|
Rhabditiform larvae
Prominent genital primordium |
|
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What form of S.stercoralis is present in soil?
|
Filariform larvae, the infective form
|
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What is the transmission route of Strongyloides stercoralis?
|
Humid tropical regions
Contact with filariform larvae in soil |
|
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Mechanism of entry of Strongyloides?
|
Skin entry, to lungs, then to upper SI
|
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What causes the erythematous rash of Strongyloides?
|
Small amount of Rhabditiform larvae maturing into Filariform larvae while still in bowel, then entering skin of the perianal regoin
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What is the major risk of stronglyoides in AIDs patients?
|
Dissemination of migrating larvae to other organs?
|
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Treatment of Strongyloides stercoralis?
|
Ivermectin
|
|
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What is the patient presentation of Echinococcus granulosus?
|
Exposure to Canines
Fullness in RUQ International Travel/Residence Fever, Chills, JAUNDICE |
|
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What is present upon CT imaging of Echinococcus patients?
|
Large multinucleated cysts with bile duct obstruction
|
|
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Characteristic microbiologic property of Echinococcus patients?
|
Hooklets
these are from the protoscolices within the hyatid cysts |
|
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Pathogenesis and Epidemiology of Echnicoccus?
|
Worms reside in dog intestine
Humans gain by consuming foods infected by dog fecies *Oncospheres* release --> cysts Mass forms, Biliary obstruction |
|
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Cause of Alveolar Hydatid Disease?
|
Echinococcus multilocularis
|
|
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Treatment of Echinococcus granulosus?
|
Surgery is #1
Albendazole |
|
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How does a patient with Schistosoma masoni present?
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Hepatosplenomegaly
Eosinophilia Hematemesis Travel/Residence in endemic area RUQ pain, N/V/D |
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Diagnostic Criteria for Schistosoma mansoni?
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O&P
Fluke eggs Prominent Spine 12-26mm long, .3-.6long |
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Endemic Area + Location of Infection:
S. mansoni S. japonicum S. haematobium |
mansoni is SA/Africa, InfMesVein
japonicum is Asia, SupMesV haematobium is Africa+MEast, urinary bladder and ureters |
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Pathogenesis of Schistomes?
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Miracidia in water --> snails
*Cercariae leave snail, penetrate human skin* shed forked tail, form Schistomulae |
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Major histologic appearance of Schistomes?
Presentation? |
egg surrounded by granulomas caused by Th2 reaction
PortalHT, hematemesis, hepatosplenomegaly |
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Treatment of Schistosoma mansoni?
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Praziquantel
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Acute Schistosomiassis with serum sickness caused by S japonicum
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Katayama Fever
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Patient presentation with HAV infection?
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N/V/fatigue/loss of appetite
Jaundice, dark urine, pale stools Elevated ALT/AST Hepatomegaly without splenomegaly |
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Serologic values in HAV/HBV/HCV?
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1 elevations of ALT/AST over 500
2 ALT>AST |
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ALT and AST values in Alcoholic liver damage?
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AST>ALT, rarely above 500
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Detection of HAV in blood?
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RT-PCR for HAV RNA
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Microbiologic characteristics of HAV?
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27nm +ssRNA
Picornaviridae icosahedral nonenveloped |
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HAV transmission?
Incubation period? Infectivity time? Infection type? |
Food workers, shellfish, daycare ctr
30 days, shortest 2 weeks before jaundice, 1 week after Never chronic |
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When is passive immunity possible for HAV?
Vaccine available? |
within 2 weeks following exposure can prevent onset in 80-90% of cases
Killed vaccine is available to anyone >2 years old |
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Pruritus
Jaundice Fever/Chills/Malaise Hepatomegaly ^^^^ALT/AST, ^^Lymphocytes |
HBV (HCV)
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Micro features of HBV?
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42nm dsDNA of hepadaviridae
27nm HBc 22 nm HBs |
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Primary component of HBV vaccine?
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HBsAg
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Possible Transmission routes of HBV? |
Sex
IV Tattoo Perinatal |
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After patients recover from HBV, ____ is no longer present in the blood by 3 months
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HBsAg
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The presence of ___ in the blood following acute HBV infection generally suggests recovery and immunization
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IgG-HBs
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igG HB_ persists indefinitely as a marker for past HBV infection
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IgM-HBc
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A diagnosis of acute HBV infection is made on the basis of detection of IgM-HB_ in the blood
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IgM-HBc
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In patients with chronic HBV infection, both ____ and ____ remain present, whereas ____ is variably present
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HBsAg and IgG-HBc persistent
HBeAg variable (only shows ACTIVE infection) |
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Presence of ____ longer than 6 months shows chronic HBV infection
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HbsAg
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Serologic difference between Chronic Healthy Carrier and Chronic Active Hepatitis?
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HBcAg present in Active only
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Treatment for Acute HBV?
Chronic? |
None
INF, Lamivudine, Adefovir |
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Vaccine for HBV?
What should be given to sexual partners? |
recombinant
the recombinant vaccine and HBIg |
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Clinical Presentation of HCV?
Biopsy? |
IV Drugs, Blood Transfusions
^ALT/AST Bridging Necrosis |
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Micro Characteristics of HCV?
Term for the multiple genotypes? |
50nm icosahedral enveloped +ssRNA
Flaviviridae Quasispecies |
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Incubation period of HCV?
Typical presentation in acute phase? |
6-7 weeks
80% asymptomatic during acute, some mild symptoms like all other Hep |
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Definition of HCV resolution?
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sustained absence of HCV RNA
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Diagnosis of HCV?
ALT level characteristics? |
Enzyme Immunoassays (EIAs)
RecombinantImmunoblotAssay (RIBA) for HCV-AB Fluctuating ALT levels |
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Treatment for HCV?
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Pegylated INF and Ribavirin
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Cause of rash in Chronic Hepatitis?
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Immune complex-associated vasculitis
also arthritis T3 HS reactions |
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Which hepatitis is related to imported berries?
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Hepatitis A
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MCC Liver failure and transplantation? |
HCV
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