Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
30 Cards in this Set
- Front
- Back
Out of the Hepatitis viruses, which are DNA and which are RNA? Which are transmitted fecal-orally and which are parentally (via blood)? Which are capable of acute viral hep and which are capable of chronic hep?
|
DNA - only Hep B (HBV)
RNA - all the rest "Hep B is the Black sheep!" A and E are the only ones that are transmitted fecal-orally. B,C,D are transmitted via blood All the hep viruses are capable of acute viral hepatitis, but only B,C,D are capable of chronic hep |
|
hepatitis A is NAKED/ENVELOPED with __RNA (____ sense)
|
NAKED, ss, positive
hep A is nice, naked and weaksauce (compared to hep B!) |
|
most common vaccine-preventable disease among unprotected travelers
|
hep A (incubation period = 1 month)
|
|
clinical manifestation of hep A
|
acute viral hepatitis - self-limitng fever, malaise, nausea (often asymptomatic)
- inc liver enzymes (bc virus causes liver necrosis) and inc bilirubin (due to poor fxning of liver) |
|
T or F. risk of jaundice/fatal hepatitis increases with age.
|
T.
|
|
how do you diagnose Hep a?
|
serology!!
anti-HAV IgM means currently active infection, whereas anti-HAV IgG indicates old infection and no active dz |
|
Hep E is part of the _____ family; it's structure is ENVELOPED/NAKED and ___ RNA.
|
hepeviridae; NAKED; ssRNA (just like hep a!)
|
|
what's the population with the highest rate of attack for hep E
|
young adults/adolescents (due to possible sexual contact) though usually mode of transmitssion is fecal-oral
|
|
compare incubation time of hep A vs. hep E
|
hep A- 1 month
hep E - 45 days |
|
what population does hep E have a high mortality rate in? How do you Dx it?
|
pregnant women (15-25% mortality rate)
dx: IgM or rising IgG to HEV |
|
Why is hepatitis B consided Big and Bad?
|
Big - its a lot larger and TOUGHER than hep A (enveloped, dsDNA)
|
|
replication in hep B utilizes what?
how does hepatic injury occur with hep B? |
RNA intermediate
injuty to liver most likely occurs due to CD8 killing of infected hepatocytes (hep b virus replicates in hepatocytes) |
|
HBsAg =_______
anti-HBsAg= _____ IgM anti-HBcAg= _______ IgG anti-HBcAg=______ Total anti-HBc HBeAg=_______ anti-HBeAg=_______ which of the above antigens in Hep B is associated with liver cancer? |
incubation or current infection
immunity, cure, NO ACTIVE DZ!! current ACUTE infection old infection current or prior infection high infectivity, virus going wild! low infectivity HBeAg |
|
how is hep B transmitted
|
parenterally (via body fluids like blood, wound exudates)
half of new infections in the US are sexually transmitted |
|
what heppens when a pregnant mother is HBeAg positive?
|
this means that there's a hugely increased risk of neonatal infection with hep b and needs intervention (ie. baby needs vaccine)
|
|
incubation period of hep b vs. hep a and hep e?
|
hep b = 90 days
hep a = 1 month hep e = 45 days |
|
young children are more like to develop ACUTE/CHRONIC infection of hep B
|
chronic (but often asymptomatic)
risk of chronic infection dec with age; risk of symptomatic infection inc with age |
|
what are 2 complications of chronic infection with hep B?
|
- hepatocellular carcinoma
- cirrhosis (permanent liver scarring and loss of hepatocytes) |
|
How do you prevent Hep B? (3)
|
- vaccine of HBsAg
- post-exposure IgG - screening of pregnant women for HBeAg - universal immunization of infants |
|
treatment of chronic infections of Hep B (2)
|
interferons (w/ or w/o steroids)
nucleoside analogues |
|
co-infection b/w what two hepatitis viruses is common?
|
hep B and D
- in fact, hep D REQUIRES HBV infection (can't independently establish infection by itself) "Hep D Depends on B" |
|
Hep D is uniquely coated with ____ antigen and is __RNA.
|
coated with HBsAg
ssRNA (encodes delta antigen) |
|
what are the 2 ways HDV can infect humans?
|
1) co-infect with HBV (enter parenterally at the same through IV drug use, blood transfusion, etc)==> generally resolves with anti-HBsAg, which ends both infetctions
2) superinfection: HDV infects person with chronic HBV infection==> severe and chronic infection of both because pt can't make anti-HBsAg (higher incidnce of fulminant hep, cirrhosis, chronic liver disease with higher mortality) |
|
Dx of hep D? vaccines?
|
IgM anti-HDV - active infection
IgM anti-HBc - distinguishes co-infetion and superinfection vaccine - prophylaxis before or after exposure with HBsAg vaccine to prevent HBV infection will prevent coinfection (best way to prevent is to control HBV infection) |
|
Which hepatitis viruses have single serotype?
which one has multiple genotypes? |
single serotypes - hep A and E (so vaccine is effective)
multiple genotypes - hep C (so drugs are less effective) |
|
most common cause of chronic viral hepatitis and liver disease requiring transplantation in the US
|
hep C (bc most Hep C infections are chronic)
"C for Chronic!" |
|
structure of hep C; incubation period?
|
enveloped, ssRNA (positive sense)
incubation - 6 wks |
|
which hepatitis viruses are associated with carcinoma?
|
hep B and C
|
|
clinical manifestations of hep C
|
- acute infection (mostly asymptomatic) ==> followed by chronic infection and complicated by cirrhosis and liver cancer
- extra-hepatic manifetations (immune mediated like glomerulonephritis) - associated with non-Hodgkin's B cell lymphoma |
|
Dx of hep c
Tx of hep C |
ELISA to screen
RIBA to confirm PCR to monitor therapy Tx: interferon and ribavirin - avoid alcohol, vaccinate against HAV and HBV - hepatic ultrasounds to test for liver cancer |