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89 Cards in this Set
- Front
- Back
Are viruses living? Can they be killed? |
They are not living therefore they cannot be killed however they can be inactivated or re activated |
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Most of the common diseases are... |
from viruses |
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Where is the best place to see jaundice? |
In the sclera of the eye and this is true for all racial backgrounds |
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How are Hepatitis A and Hepatitis E transmitted? |
they are transmitted fecal orally |
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What hepatitis viruses have a envelope and what hepatitis viruses don't? |
Hepatitis A and E do not have a envelope Hepatitis B,C,D do have a lipid envelope |
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Why is not having a envelope important for hep A and hep E that transmit the virus focal orally? |
Its important for the transmission because it allows HAV and HEV to be stable in bile -They are harder to destroy and easier to pass along. Whereas enveloped are very easily destroyed. |
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What are some risk factors for Hep A? |
The most common risk factor is being in close contact with someone who has an active case of Hep A others include: -sexual behaviour -Food and water borne transmission -Travelling to another country with high prevalence of hep A |
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How can you prevent Hep A? |
Getting vaccinated especially if your going on a trip to a place where there is a high prevalence of Hep A |
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Who are the people you should be worried about? |
Many viruses are shed in large numbers before the person is symptomatic; therefore, its not the coughing and sneezing person that you have to be worried about its the people that are going to start sneezing and coughing the following day or the next and this is what can cause explosive outbreaks |
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What family does Hep A belong to? |
Its a member of the Hepatovirus genus of the Picornavirus family (pico - small ran virus) |
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What is the incubation period of Hep A? |
15-45 days but the virus is present in the blood and is shed in the stools within a few days of exposure increasing just before the onset of symptoms |
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What are the symptoms of Hep A? |
symptoms usually begin abruptly -fever, myalgia, malaise, anorexia, nausea and vomiting and occasion RUQ pain -Dark coloured urine, light clay coloured stools and frank icterus (jaundice) |
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How do you diagnose Hep A? |
the first thing the doctor usually sees is an increase in HAV IgM antibodies then they will see an increase in AST ALT and Bilirubin -- obviously after the patient has all these symptoms |
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Who is Hep A usually almost never recognized in? |
Hep A is usually never recognized in children under the age of two (d/t being mildly ill or asymptomatic) |
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What if someone has a high antibody levels of HAV but have no history of hepatitis? |
It probably reflects infection at an early as that went unrecognized |
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People over 40 are at increased risk of developing what? |
Fulminant hepatits A and transplantation may be indicated (fulminant = severe and sudden) |
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How long are Hep A shots good for? |
1 shot of Hep A is good for 3 years
2 shots of Hep A is good for life |
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What is Hep E? (what kind of virus and similar to, and incubation period, enveloped, transmission?) |
it is a calicivirus similar to Hep A Incubation period is longer than Hep A (about 40 days) not enveloped and enteric transmission (focal oral) |
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How do you diagnose Hep E? |
is made by detecting HEV IgG antibody in the absence of other markers for other hepatitis viruses |
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Is there a vaccine available for Hep E?
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No |
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What does Hep E cause during pregnancy? |
If a women gets infected with Hep E during her third trimester of pregnancy there is a 15-20% case of fatality rate. |
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What is Hep C? (what type of virus, progression) |
it is a flavivirus It is indolent (lazy) and slowly progressive liver disease that is asymptomatic until the late development of decompensated liver disease and often liver cancer |
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How many people have symptoms for Hep C? |
only 5% of cases of hep C have symptoms |
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How many people develop chronic infection of Hep C? |
70% develop chronic infection but then about 40% resolve spontaneously |
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How is Hep C usually detected? |
Usually detected by elevated serum transminidase and confirmed by HCV antibodies |
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Anitbodies are a marker of what? |
antibodies are a marker of infection NOT immunity |
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What usually causes Hep C? |
due to intravenous drug use often in the past or due to one single episode you used to be able to get it from untreated or non heat treated blood products prior to the 1980s - can't get it now because its all treated |
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What are risk factors for Hep C liver fibrosis? |
age >40 male sex alcohol consumption >50mg a day immune status genotype of the virus |
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Whats important for hep C treatment? |
abstinence from alcohol (less than 4 drinks weekly)
safe sex councelling interferon a and ribovirin liver transplant if indicated for end stage liver disease or some cases of hepatocellular carcinoma |
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When is heptocellular carcinoma rarely seen?
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its rarely seen prior to 15 years of infection and also rarely seen in the absence of liver cirrhosis |
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Is there a vaccine for Hep C? |
no |
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Hep C and alcohol .... |
progress liver cirrhosis and liver cancer |
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What family us Hepatitis B from? |
Hepadnaviridae |
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Why is this virus different from all other viruses? |
Hep B is the only virus known to have both DNA and RNA. Usually a virus will have one or the other |
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Where is Hep B an endemic? |
subsaharan africa and pacific rim |
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What do we hope in terms of hep B? |
This disease we can eliminate if we can get enough money and determination we are hoping it will be the 4th eliminated disease. |
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What can Hep B range from? |
it can be asymptomatic or fulminant (sudden and severe) |
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Whats the percent of chronic infections in people with Hep B? |
1% of healthy adults will have chronic infection from Hep B |
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How many people with chronic Hep B infection? |
350 million |
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What is the pathogenesis of Hep B? |
It is mainly due to cell mediated immune response to the host - virus triggers an auto immune response |
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Whats the incubation period for Hep B? |
50-150 days |
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What is the marker for infectivity for Hep B? And ____ becomes positive before an elevation in _______. |
HBSAg - this is not an infectious particle itself And HBSAg becomes positive before elevation in serum transaminase |
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How do you know someone is recovering from Hep B? |
Normally HBSAg will disappear and HBSAb will appear which is a marker of immunity and recovery |
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What can you do during the short window period when the HBSAg and HBSAb are absent? |
You can check the HB core antigen IgM antibody (through liver biopsy) - this is not routinely ordered |
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What other thing will be high in the blood if infected with Hep B? |
E antigen along obviously with HBSAg |
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What other tests can you do to diagnose Hep B? |
HBe antigen - high infectivity HBe antibody -marker of recovery HB DNA - marker of infectivity that can also be used to monitor therapy |
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What are specific symptoms of Chronic Hep B? |
usually mild and nonspecific - lack of energy and malaise myalgia, artralgias, skin rash and glomerulonephritis may occur when circulating immune complexes are present |
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What can happen if you have chronic hep B? |
it may go unnoticed until you have cirrhosis and even end stage live disease |
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what is a characteristic of chronic hep B? |
characterized by persistent HBSAg and failure to develop HBSAb for 6 months |
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how many percent per year spontaneously become immune? |
1% per year spontaneously become immune |
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What should you do in terms of the travelling? |
usually if you go on a short trip you don't need a vaccine as usually you won't be having sex with multiple people or injecting drugs Hep A vaccine is more important than Hep B |
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Does the vaccine work after you've been exposed to Hep B? |
Yes |
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How is Hep B transmitted? |
primarily through blood, serum, plasma but all body fluids are infectious including ejaculate, vaginal recreations and saliva sharing needles, razors and sexual contact |
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Explain how Hep B can infect you |
intact skin is impermeable to HBV however if it touches mucosal surfaces, abrasions, open wounds it can facilitate transmission Also a baby can get vertical transmission at placental seperation |
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How can a baby get infected with vertical transmission at placental separation |
during pregnancy blood for the mother is separate from the blood for the baby and when the baby is born there is chance it will get Hep B. |
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Does it take a lot of a little bit of "stuff" to give you hep B? |
only takes a TINY TINY amount of blood or bodily fluid to get you infected |
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How can you prevent Hep B? |
Vaccines especially those with lifestyle risk factors (sexual partners, medical personals, household contacts with hep b, infants of mothers with hep B) |
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What is Hep D? |
An RNA virus dependant on upon the enveloped proteins produced by hep B - therefore it can only exist with hep B |
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How is it primarily transmitted? |
like hep b it must coexist with it is blood borne however sexual and perinatal transmission is rare |
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How many people are affected world wide from hep D? |
25 million |
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Is there a vaccine for Hep d? |
no; however, there is a vaccine for hep B and that can help prevent hep D |
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Diarrhoea is defined as |
is defined by the passage of more than 300 grams of stool per day |
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What is the main weight of the stool and whats the main cause of diarrhea? |
60-90% of stool weight is water, excretion of excess focal water is the main cause of diarrhea |
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What is the term acute diarrhea mean? |
is means two weeks duration or less and is often associated with infectious causes |
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When is the term acute gastroenteritis used? |
when vomitting is also present along with diarrhea |
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What can be other causes of diarrhea? |
stress, extra spicy food ect |
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What family does rota virus belong to? |
it belongs to reoviridae family |
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What is Rotavirus a common cause of ? |
common cause of outbreaks of diarrhea in 6 months to 2 years of age |
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what percent of toddlers by the age of 4 are seropositive ? |
90% of infants by the age of 4 are seropositive for rotavirus |
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What is the incubation period of rotavirus? |
incubation period of 1-3 days then abrupt onset of vomiting followed with watery diarrhea |
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how long does the vomiting and diarrhea usually last? |
vomiting last for 1-3 days but then the diarrhea continues for about a week |
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What can be very dangerous in young children? |
Vomiting and watery diarrhea can be dangerous cause of dehydration. the younger the kids are and the more they vomit and have diarrhea the more likely they will die of dehydration -- its important to keep them well hydrated! |
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Where does the rotavirus localize? |
It localizes in the duodenum and proximal jejunem and results in the destruction of villous epithelium |
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How do you diagnose rotavirus? |
electron microscopy of stool or detection of antigen via latex agglutination or enzyme immunoassay |
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How do you treat rotavirus? |
primarily oral rehydration and an oral vaccine is available |
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What are three keys things you need to remember about rotavirus? |
it affects kids can vaccinate takes a long malabsorption period after you've had rotavirus (usually takes 3-8 weeks to recover from malabsorption) |
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Whats norovirus ? (aka, what family) |
aka small around viruses of diarrhea RNA virus in the caliciviridae family |
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Who is it more common in? |
Adults and older children |
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What does it usually cause? |
large outbreaks of diarrhea |
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What percent of adults by the 5th decade are seropositive? |
50% |
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What is the incubation period of the Norwalk virus? |
10-52 hours |
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What are the symptoms of Norwalk? |
abrupt onset of vommiting and diarrhea |
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How long does the illness last ? |
1-2 days |
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how do you diagnose Norwalk? |
electron microscopy of the stool |
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how is normal virus transmitted? |
fecal oral |
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How can you break transmission |
Good hygiene is required to break the transmission |
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When does viral shedding occur? |
viral shedding occurs for 3-4 days after the onset of illness |
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3 things about Norwalk virus |
big outbreaks doesn't last long but severe |
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