Chronic Hepatitis and Carrier States
19 Questions
1 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the best determinant of chronicity in hepatitis B virus (HBV) infection?

  • The level of serum transaminases
  • Duration of exposure to the virus
  • The presence of jaundice
  • Age at the time of infection (correct)

Which of the following is NOT a characteristic of a 'healthy carrier' of HBV?

  • Presence of HBsAg
  • Lack of significant inflammation in liver biopsy
  • High serum HBV DNA levels (correct)
  • Normal aminotransferases

Which virus is identified as the most common cause of chronic viral hepatitis?

  • Hepatitis C virus (HCV) (correct)
  • Hepatitis A virus (HAV)
  • Hepatitis E virus (HEV)
  • Hepatitis B virus (HBV)

What is a common symptom of chronic hepatitis?

<p>Persistent fatigue (C)</p> Signup and view all the answers

In which age group does the carrier state of HBV infection occur in more than 90% of cases?

<p>Infants and young children (A)</p> Signup and view all the answers

Which histologic change is specifically indicative of HBV infection?

<p>Ground-glass hepatocytes (A)</p> Signup and view all the answers

What role do 'carriers' of hepatotropic viruses play in public health?

<p>They serve as reservoirs for infection (C)</p> Signup and view all the answers

Which of the following is the least common symptom associated with chronic hepatitis?

<p>Severe abdominal cramps (B)</p> Signup and view all the answers

In non-endemic areas, what is the approximate percentage of HBV infections acquired by adults that produce a carrier state?

<p>Less than 1% (D)</p> Signup and view all the answers

What is the main feature of ballooning degeneration in hepatocyte injury?

<p>Swelling with empty cytoplasm (B)</p> Signup and view all the answers

What is indicated by the presence of Councilman bodies in a liver biopsy?

<p>Apoptosis of hepatocytes (B)</p> Signup and view all the answers

Which cell types are typically found in the inflammation of mild chronic hepatitis?

<p>Lymphocytes, macrophages, and occasional plasma cells (B)</p> Signup and view all the answers

What characterizes the histological features of chronic hepatitis?

<p>Ranging from mild inflammation to severe liver damage (B)</p> Signup and view all the answers

What is the hallmark of chronic liver damage in the context of hepatitis?

<p>Deposition of fibrous tissue (B)</p> Signup and view all the answers

What does continued interface hepatitis and bridging necrosis indicate?

<p>Progressive liver damage (B)</p> Signup and view all the answers

In chronic hepatitis due to HCV, which finding is commonly observed?

<p>Lymphoid aggregates and mild to moderate fatty changes (D)</p> Signup and view all the answers

What is the sequence of fibrous tissue deposition during chronic liver damage?

<p>Initial portal tract fibrosis, followed by periportal and bridging fibrosis (C)</p> Signup and view all the answers

What signifies focal loss of hepatocytes in liver damage?

<p>Cell membrane rupture leading to cell death (D)</p> Signup and view all the answers

Which type of cells primarily mark sites of hepatocyte loss?

<p>Scavenger macrophages (C)</p> Signup and view all the answers

Flashcards

What is Chronic Hepatitis?

Chronic hepatitis refers to ongoing or recurring liver disease lasting longer than 6 months, indicated by symptoms, abnormal blood tests, or serological findings.

What are the common symptoms of Chronic Hepatitis?

Fatigue is the most common symptom, while milder symptoms include malaise, loss of appetite, and occasional mild jaundice.

How does age affect the risk of Chronic Hepatitis?

The younger the age at infection, the higher the chance of developing chronic hepatitis, especially with HBV.

What is the most common cause of chronic viral hepatitis?

HCV (Hepatitis C virus) is the most frequent cause of chronic viral hepatitis.

Signup and view all the flashcards

What is a 'carrier' in relation to hepatotropic viruses?

A carrier of a hepatotropic virus can be an individual without any liver disease or have non-progressive liver damage with no symptoms or disability.

Signup and view all the flashcards

Describe a 'healthy carrier' in relation to HBV.

Individuals who carry HBV without symptoms or significant liver damage are considered 'healthy carriers'.

Signup and view all the flashcards

How does the age of HBV infection affect the likelihood of becoming a carrier?

HBV infection acquired early in life in endemic areas leads to a carrier state in over 90% of cases.

Signup and view all the flashcards

What is the commonality in the morphology of acute and chronic viral hepatitis?

Hepatotropic viruses from A to E share morphologic changes in both acute and chronic hepatitis.

Signup and view all the flashcards

Describe the microscopic appearance of HBV-infected hepatocytes.

HBV-infected hepatocytes (liver cells) may show a cytoplasm packed with HBsAg (Hepatitis B surface antigen), creating large, pale, granular inclusions under a microscope.

Signup and view all the flashcards

What are the characteristics of an HCV-infected liver?

HCV-infected liver often shows clusters of immune cells within the portal tracts and areas of fatty change within the liver lobules.

Signup and view all the flashcards

Ballooning Degeneration

A type of cell injury that causes hepatocytes to swell and their cytoplasm to appear empty. It often happens in viral hepatitis.

Signup and view all the flashcards

Apoptosis

A process of programmed cell death where cells shrink, become denser, and have fragmented nuclei.

Signup and view all the flashcards

Rupture of the Cell Membrane

A type of cell death that occurs when the cell membrane ruptures, leading to the loss of hepatocytes. Scavenger macrophages clean up the debris.

Signup and view all the flashcards

Councilman Bodies

Small, densely-stained fragments of nuclei found in hepatocytes undergoing apoptosis.

Signup and view all the flashcards

Mild Chronic Hepatitis

A mild form of chronic hepatitis where inflammation is limited to portal tracts.

Signup and view all the flashcards

Chronic Hepatitis

inflammation of the liver that persists over a long period, often leading to scarring.

Signup and view all the flashcards

Interface Hepatitis

Inflammation at the interface between the portal tracts and the surrounding liver tissue.

Signup and view all the flashcards

Fibrosis

The process of scar tissue formation in the liver, which can lead to cirrhosis.

Signup and view all the flashcards

Bridging Fibrosis

Scar tissue that extends from the portal tracts towards the terminal hepatic veins, a sign of worsening liver damage.

Signup and view all the flashcards

Cirrhosis

The end stage of liver fibrosis, where significant scarring replaces normal liver tissue.

Signup and view all the flashcards

Study Notes

Chronic Hepatitis

  • Defined as symptomatic, biochemical, or serologic evidence of continuing or relapsing hepatic disease for more than 6 months.
  • Clinical features vary greatly. Some patients only show persistent elevations of serum transaminases.
  • Common symptom is fatigue; less common are malaise, loss of appetite, and mild jaundice.
  • Age at infection is the most important factor for chronicity; younger ages have higher risk.
  • HCV is the most common cause of chronic viral hepatitis. Often patients exhibit few or no symptoms.

Carrier State

  • A carrier is someone who carries a virus but may or may not have liver disease. They can be a reservoir for infection.
  • A "healthy carrier" (HBV) carries HBsAg continuously, lacks HBeAg but has anti-HBe, normal aminotransferases, low or undetectable HBV DNA, and a biopsy showing no significant inflammation/necrosis.
  • In non-endemic areas, less than 1% of adult HBV infections result in a carrier state.
  • In endemic areas, HBV infection in early life leads to a carrier state in over 90% of cases.

Morphology of Acute and Chronic Hepatitis

  • Acute and chronic viral hepatitis (types A-E) share similar morphological changes.
  • HBV-infected cells may show HBsAg spheres/tubules, causing "ground-glass hepatocytes" (pale, finely granular cytoplasm).
  • HCV-infected livers often have lymphoid aggregates in portal tracts and focal lobular macrovesicular steatosis (fatty change).
  • Acute hepatitis involves diffuse swelling (ballooning degeneration) of hepatocytes, with scattered eosinophilic remnants.
  • Cell death can occur by rupture of the cell membrane, or via apoptosis (shrinking, intensely eosinophilic cells with fragmented nuclei – Councilman bodies).

Chronic Hepatitis Histological Features

  • Chronic hepatitis ranges from mild to severe.
  • Mild cases show inflammation limited to portal tracts, with lymphocytes, macrophages, occasional plasma cells, and rare neutrophils/eosinophils.
  • Chronic HCV often displays lymphoid aggregates and mild-moderate fatty change.
  • All forms of chronic hepatitis, interface hepatitis, and bridging necrosis between portal tracts are signs of progressive liver damage.
  • Fibrosis (scar tissue) is a key feature of chronic liver damage, first appearing in portal tracts, then spreading periportally and bridging different areas.
  • Continued loss of hepatocytes and fibrosis ultimately results in cirrhosis.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Description

Explore the key concepts of chronic hepatitis and the carrier state associated with viral hepatitis infections. This quiz covers symptoms, risk factors, and the differences between healthy carriers and symptomatic patients. Test your understanding of hepatitis C and B in relation to liver disease.

More Like This

Use Quizgecko on...
Browser
Open
Browser
Browser