Giwk5- 3-29 Micro Ciral Hep

Front 1

What are the NANB viral heps technically?

Back 1

C, E, G, SEN, TTT, maybe others

Front 2

Common features of viral hepatitis?

Lab findings?

Back 2

RUQ abd pain, nausea, anorexia, fatigue, fever, jaundice, hepatomegaly

elevated liver enzymes, bilirubin in blood/urine, Alk Phos, LDH

Front 3

HAV:
1. Family of viruses?
2. stable or unstable in environment?
3. acute, chronic infection? asymptomatic, symptomatic?
4. Transmission? Where?
5. single outbreak or community?
6. Vaccine? Who gets which kind?

Back 3

1. picornaviridae, +ssRNA, one serotype worldwide (enterovirus group)
2. stable in environment
3. acute, asymptomatic infections in kids, adults quick onset "infectious hepatitis"
4. fecal-oral, crowded, poor hygiene
5. community outbreaks
6. inactive vaccine for children. killed vaccine for the military, travelers to endemic regions, high risk groups. of infection.

Front 4

Hep A pathogenesis? (incubation as well)

definitive dx of acute infection?

definitive dx of past infection?

Tx of HAV?

Back 4

intestine --> hepatocytes (replication) --> feces- incubation- 30 days
acute infection, >14 y/o

anti-HAV IgM - acute infection

anti-HAV IgG - past infection

no antiviral tx, vaccinations, children @ 1 y/o, travelers

Front 5

HBV:
1. Family?
2. Transmission?
3. How is the liver damaged?
4. When do clinical signs show up?
5. Who gets the active vaccine?
6. Who gets the passive vaccine?

Back 5

1. hepaDNA viridae, enveloped (partially) dsDNA
2. blood/semen, to liver
3. Damage to liver cells is immune mediated (due to release of toxic substances from infiltrating mononuclear cell and cytotoxic T-lymphocytes (CTLs)
4. When liver damage ensues clinical signs occur
5. children, infants, high-risk
6. health care workers

Front 6

Hep B:
General serum marker of infection: why?
Recovery/immunity to HBV by itself vs found with other Abs:
Marker of acute infection:
Marker of past/chronic infection:
active replication:

Back 6

general: HBsAg- surface is what body sees first "s"
Recovery/immunity: anti-HBsAb (alone = vaccination) (with other Ab's = recovery)
acute: anti-HBc IgM
chronic: anti-HBc IgG
active replication: HBeAg, HBV-DNA

Front 7

Serum findings in active infections of Hep B?

Serum findings in recovery?

Serum findings in chronic persistent?

Chronic active?

Back 7

HBsAg, anti-HBcAg IgM

anti-HBsAg, anti-HBcAg IgG

HBsAg, anti-HBcAg IgG, anti-HBeAg

HBsAg+, HBeAg, HBcAg IgG, DNA Pol.

Front 8

Which hepatitis often co-infects with Hep B?

What type of virus?

risk group?

Serologic dx? Which ones are more likely in chronic vs acute?

Back 8

Hep D

ssRNA, unclassified

IVDA's and partners

anti-HDV IgM (high in chronic) also found in acute, anti-HDV IgG (late in acute), HDV Ag

Front 9

Hep C:
Family, type of virus?

animal reservoir?

Transmission? 90% of who will get this?

commonly causes _________ infections.

leading cause of ______________.

Back 9

Flavivirus, +ssRNA

humans, chimps

injection, needle stick, sexual, 90%- drug users

chronic

liver transplantation

Front 10

What are the "serum transmitted" Hep viruses?

Back 10

B and D

Front 11

HBV Ag or anti found from (acute infection)...
a. 4-24 weeks
b. 6-32 weeks
c. 32+ weeks
d. 6+ weeks

Back 11

a. HBsAg
b. IgM anti-ABc
c. Anti-Hbs
d. Total anti- HBc

Front 12

Factors that promote progression/severity of Hep C:

Ability to clear virus depends on ______ response.

Back 12

EtOH, age, HIV, male, HBV

T-cell (CD4, CD8)

Front 13

Which hepatitis is not person-person transmitted?
Type of virus?
Related to what virus?
Best way to prevent Hep E infection?

Back 13

Hep E
NANB hep virus ,non-eveloped RNA genome
similar to Calciviruses
watch for contaminated H2O

Front 14

Name the type of virus for the following...
a. AKA infectious hepatitis
b. replicates via RNA intermediate
c. High risk sexual drug abusers

Back 14

a. HAV- Hep A
b. HBV- Hep B
b. HDV- Hep D

Front 15

Types of HBV chronic infections?

Incubation period?

More likely to develop chronic infection at what age?

Back 15

Chronic persistent- can still transmit but not symptomatic
Chronic active- symptomatic hepatitis

- 100 days (about)

- 0-5 yrs old

Front 16

For Acute HBV infections at what times would you see...
a. HBeAg
b. Anti- HBe

Back 16

a. 4-12 weeks
b. 12+ weeks

Front 17

1. needs HBV as a helper to code its surface protein

2. Worrisome of mortalities in pregos

Back 17

1. Hep D

2. hep E

Front 18

How does Hep D create Super-infection vs. coinfection...
Which is usually acute vs. chronic?

Back 18

Co-infection usually acute- D got while getting B

Super- usually chronic after already having B you get D

Front 19

For superinfection of HDV how do you prevent?

How do you cure/prevent coinfection

Back 19

stop shitty behavior to prevent developing super infection

- Coinfection if you cure B you cure D

Front 20

What serology studies find for Hep E?

Back 20

anti- HEV IgG, anti HEV IgM, viral detection

Front 21

What is the diagnostic process for HCV?

Back 21

1. anti- HCV first with ELISA
2. Confirm with RIBA test for RNA specific for Hep C
3. HCV PCR qualitative- (reverse transcriptase) to find out if presentand quantitative to find out how much present

Front 22

Back 22

Front 23

1.1 Slutty Drugged Waitress Test show:
– HAV IgG: positive
– HAV IgM: negative
– HBsAg: positive
– Anti-HBsAg: negative
– Anti-HBcAg IgM: positive
– HBeAg: positive
– Anti-HBeAg: negative
– Anti-HCV: negative

Back 23

Start with A's and then go C and then B
HAV IgG- not active then skip B
See- Anti-HCV neg so no Hep C
See "M" for HBV meaning she has acute infection, then others are used to confirm... but keep CHRONIC IN MIND IF PERSON IS DIRTY WHORE

Front 24

1.2 Six month follow up of slutty waitress with normal liver enzymes
– HBsAg: positive
– Anti-HBsAg: negative
– Total Anti-HBcAg: positive
– Anti-HBcAg IgM: negative
– HBeAg: negative
– Anti-HBeAg: postive

Back 24

more like chronic peristent not active, but can still transmit infections

Front 25

1.3 Two years later of dirty waitress:
– HAV: IgG positive
--HAV IgM: negative
– HBsAg: positive
-Anti HBsAg: negative
– Total Anti-HBcAg: positive
– Anti-HBcAg IgM: negative
– HBeAg: positive
– HBV DNA: positive
– Anti-HDV IgM: positive
– Anti-HCV: negative

Back 25

now she has D most likely superinfection

Front 26

Back 26