Podcast
Questions and Answers
What is the most common cause of hepatitis?
What is the most common cause of hepatitis?
How is Hepatitis A primarily transmitted?
How is Hepatitis A primarily transmitted?
When is a person with Hepatitis A most infectious?
When is a person with Hepatitis A most infectious?
Which of the following is NOT a characteristic of Hepatitis A?
Which of the following is NOT a characteristic of Hepatitis A?
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Which of these is a potential source of Hepatitis A infection?
Which of these is a potential source of Hepatitis A infection?
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What type of cells cause liver damage in Hepatitis A?
What type of cells cause liver damage in Hepatitis A?
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What is the duration of infectivity for Hepatitis A?
What is the duration of infectivity for Hepatitis A?
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Which of these is a preventative measure for Hepatitis A?
Which of these is a preventative measure for Hepatitis A?
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Which of the following clinical manifestations can be observed during the physical examination of a patient with acute Hepatitis B?
Which of the following clinical manifestations can be observed during the physical examination of a patient with acute Hepatitis B?
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What is the primary focus of drug therapy for Hepatitis B?
What is the primary focus of drug therapy for Hepatitis B?
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Which of the following is NOT a complication of Hepatitis B?
Which of the following is NOT a complication of Hepatitis B?
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What is the significance of genotyping in Hepatitis B?
What is the significance of genotyping in Hepatitis B?
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Which of the following is a subjective data point that can be collected during the nursing assessment of a patient with Hepatitis B?
Which of the following is a subjective data point that can be collected during the nursing assessment of a patient with Hepatitis B?
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Which of the following is a first-line therapy for Hepatitis B?
Which of the following is a first-line therapy for Hepatitis B?
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Which of the following aspects is NOT considered essential in the collaborative care of a Hepatitis B patient?
Which of the following aspects is NOT considered essential in the collaborative care of a Hepatitis B patient?
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What is the period of maximum infectivity for a patient with Hepatitis B?
What is the period of maximum infectivity for a patient with Hepatitis B?
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Based on the laboratory results, which type of hepatitis does A.M. have?
Based on the laboratory results, which type of hepatitis does A.M. have?
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Which of the following is a likely mode of transmission for A.M.'s hepatitis infection?
Which of the following is a likely mode of transmission for A.M.'s hepatitis infection?
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Which of these laboratory results indicates liver damage in A.M.?
Which of these laboratory results indicates liver damage in A.M.?
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What is the significance of a positive anti-HAV IgM result?
What is the significance of a positive anti-HAV IgM result?
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Why is it important for the healthcare provider to investigate possible contacts of A.M.?
Why is it important for the healthcare provider to investigate possible contacts of A.M.?
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Which of these interventions is NOT typically recommended for A.M.'s hepatitis?
Which of these interventions is NOT typically recommended for A.M.'s hepatitis?
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Which of these tests would be LEAST relevant for diagnosing A.M.'s current condition?
Which of these tests would be LEAST relevant for diagnosing A.M.'s current condition?
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Which of these laboratory values is most likely to be elevated in someone with Hepatitis A?
Which of these laboratory values is most likely to be elevated in someone with Hepatitis A?
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What is a common symptom associated with acute hepatitis C infection?
What is a common symptom associated with acute hepatitis C infection?
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Which of the following is NOT a common mode of transmission for hepatitis C virus?
Which of the following is NOT a common mode of transmission for hepatitis C virus?
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What is the typical duration of the acute hepatitis C phase?
What is the typical duration of the acute hepatitis C phase?
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Which of the following is a potential complication of chronic hepatitis C infection?
Which of the following is a potential complication of chronic hepatitis C infection?
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What is the most common clinical manifestation of hepatitis C, especially in individuals with long-term infections?
What is the most common clinical manifestation of hepatitis C, especially in individuals with long-term infections?
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What is the primary mechanism of liver damage in acute hepatitis C infection?
What is the primary mechanism of liver damage in acute hepatitis C infection?
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How is jaundice associated with hepatitis C infection?
How is jaundice associated with hepatitis C infection?
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What is the typical progression of the convalescent phase following acute hepatitis C infection?
What is the typical progression of the convalescent phase following acute hepatitis C infection?
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What is the recommended treatment for acute viral hepatitis?
What is the recommended treatment for acute viral hepatitis?
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What percentage of individuals with HCV will develop cirrhosis over 20-30 years?
What percentage of individuals with HCV will develop cirrhosis over 20-30 years?
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Which of the following is NOT a possible complication of HCV?
Which of the following is NOT a possible complication of HCV?
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What is the primary purpose of HCV RNA testing?
What is the primary purpose of HCV RNA testing?
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Which of the following factors is a strong predictor of response to HCV therapy?
Which of the following factors is a strong predictor of response to HCV therapy?
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What does the presence of anti-HCV antibodies indicate?
What does the presence of anti-HCV antibodies indicate?
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What is the significance of genotyping HCV in patients with positive HCV antibody tests?
What is the significance of genotyping HCV in patients with positive HCV antibody tests?
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What is the main rationale for bed rest in patients with acute viral hepatitis?
What is the main rationale for bed rest in patients with acute viral hepatitis?
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What is the recommended time frame for administering the second dose of the hepatitis B vaccine?
What is the recommended time frame for administering the second dose of the hepatitis B vaccine?
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According to the information provided, how effective is the hepatitis B vaccine in preventing infection?
According to the information provided, how effective is the hepatitis B vaccine in preventing infection?
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What is the recommended fluid intake for a patient with hepatitis B?
What is the recommended fluid intake for a patient with hepatitis B?
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A client with hepatitis B is being discharged home. Which of the following instructions should the nurse include in the discharge plan to help prevent the spread of the virus?
A client with hepatitis B is being discharged home. Which of the following instructions should the nurse include in the discharge plan to help prevent the spread of the virus?
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What is the recommended dietary approach for a client with hepatitis B?
What is the recommended dietary approach for a client with hepatitis B?
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What is the recommended treatment for post-exposure prophylaxis of hepatitis B?
What is the recommended treatment for post-exposure prophylaxis of hepatitis B?
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What kind of diet is recommended for a client hospitalized with viral hepatitis?
What kind of diet is recommended for a client hospitalized with viral hepatitis?
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A client with chronic hepatitis B should avoid what to prevent disease progression?
A client with chronic hepatitis B should avoid what to prevent disease progression?
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Flashcards
Ambulatory Care
Ambulatory Care
Outpatient care provided to patients who do not require hospitalization.
Hepatitis A
Hepatitis A
Inflammation of the liver caused by the Hepatitis A virus, typically transmitted through fecal-oral route.
Transmission Prevention
Transmission Prevention
Methods taught to patients to avoid spreading Hepatitis A, including hygiene and food handling.
Incubation Period of Hepatitis A
Incubation Period of Hepatitis A
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Infectivity of Hepatitis A
Infectivity of Hepatitis A
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Sources of Hepatitis A Infection
Sources of Hepatitis A Infection
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Medication Education for Hepatitis
Medication Education for Hepatitis
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Nutritional Needs in Hepatitis Care
Nutritional Needs in Hepatitis Care
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Acute vs Chronic Hepatitis
Acute vs Chronic Hepatitis
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Symptoms of Acute HBV
Symptoms of Acute HBV
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Complications of Hepatitis
Complications of Hepatitis
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Liver Function Tests
Liver Function Tests
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Genotypes of HBV
Genotypes of HBV
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Collaborative Care
Collaborative Care
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First Line Therapies for HBV
First Line Therapies for HBV
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Hepatomegaly
Hepatomegaly
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Splenomegaly
Splenomegaly
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Icteric Urine
Icteric Urine
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Anti-HAV IgM
Anti-HAV IgM
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Hepatitis B Tests
Hepatitis B Tests
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Nutritional Interventions
Nutritional Interventions
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Hepatitis A Transmission
Hepatitis A Transmission
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Vaccine Dosing Schedule
Vaccine Dosing Schedule
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Vaccine Effectiveness
Vaccine Effectiveness
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Post-Exposure Prophylaxis
Post-Exposure Prophylaxis
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Jaundice Assessment
Jaundice Assessment
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Nutrition in Hepatitis
Nutrition in Hepatitis
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Fluid Intake Recommendation
Fluid Intake Recommendation
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Alcohol and Chronic HBV
Alcohol and Chronic HBV
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Family Vaccination Importance
Family Vaccination Importance
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Liver Complications of HCV
Liver Complications of HCV
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Mortality Rate of HCV
Mortality Rate of HCV
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Initial Testing for HCV
Initial Testing for HCV
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Anti-HCV Antibody Test
Anti-HCV Antibody Test
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Role of HCV Genotyping
Role of HCV Genotyping
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Symptoms during Physical Assessment
Symptoms during Physical Assessment
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Drug Therapy for Acute HCV
Drug Therapy for Acute HCV
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Management of Acute Viral Hepatitis
Management of Acute Viral Hepatitis
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Etiology of Hepatitis C
Etiology of Hepatitis C
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Mode of Transmission
Mode of Transmission
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Acute Infection Effects
Acute Infection Effects
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Clinical Manifestation
Clinical Manifestation
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Acute Hepatitis Symptoms
Acute Hepatitis Symptoms
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Jaundice Indicators
Jaundice Indicators
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Convalescent Phase
Convalescent Phase
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Chronic Hepatitis C Risk
Chronic Hepatitis C Risk
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Study Notes
Hepatitis Overview
- Hepatitis is liver inflammation
- Viral hepatitis is the most common cause
- Other causes include drugs (alcohol, chemicals), autoimmune diseases, and metabolic abnormalities
Viral Hepatitis Types
- Types A, B, C, D, and E are the main viral types
- Note: Focus on A, B, and C in this study guide.
Hepatitis A Virus (HAV)
- Ranges from mild to acute liver failure
- Not a chronic disease
- Incidence decreased with vaccination
- RNA virus, transmitted via the fecal-oral route
- Associated with contaminated food or water
Hepatitis B Virus (HBV)
- Can cause acute or chronic disease
- Incidence decreased with vaccination
- DNA virus
- Transmitted perinatally and percutaneously, meaning from mother to child, and through cuts/open sores/blood entry points
- Exposure includes infectious blood, blood products, or other body fluids
Hepatitis B Virus (HBV) - At-Risk Populations
- Men who have sex with men
- Household contacts of chronically infected individuals
- Patients undergoing hemodialysis
- Healthcare workers
- Transplant recipients
Hepatitis C Virus (HCV)
- Can be acute (asymptomatic) or chronic (liver damage)
- RNA virus, transmitted percutaneously
- Risk factors include IV drug use, high-risk sexual behaviors, occupational exposure, dialysis, and perinatal exposure
Hepatitis D Virus (HDV)
- Also known as delta virus
- Defective single-stranded RNA virus
- Cannot survive without HBV
- Transmitted percutaneously
- No vaccine available
Hepatitis E Virus (HEV)
- RNA virus, transmitted via the fecal-oral route
- Typically associated with contaminated water
- Commonly encountered in developing countries
- Few cases in developed countries, like the United States
Pathophysiology
- Acute infection: widespread destruction of hepatocytes (liver cells)
- Liver cells regenerate in a normal form after infection resolution
- Chronic infection: can cause fibrosis and progress to cirrhosis
- Antigen-antibody complexes activate the complement system, leading to systemic manifestations including rashes, angioedema, arthritis, fever, and malaise.
Hepatitis Case Study
- A 30-year-old man (A.M.) was admitted to the hospital with fatigue, lack of appetite, headaches, and jaundice.
- Symptoms progressed over a few days.
- One month prior, he was in Mexico and consumed a lot of seafood and local foods.
- He also reported having sex with a prostitute in Mexico.
- The health care provider suspected acute Hepatitis A
Clinical Manifestations
- Acute and chronic hepatitis
- Many patients are asymptomatic
- Symptoms can be intermittent or ongoing, including malaise, fatigue, myalgias/arthralgias, and right upper quadrant tenderness
- Acute phase: symptoms during incubation, anorexia, lethargy, weight loss, fatigue, nausea/vomiting, and RUQ tenderness; distaste for cigarettes
- Physical examination: hepatomegaly, lymphadenopathy, and splenomegaly, dark/clay-colored stools, jaundice, pruritus, and possible low-grade fever
- Convalescent phase: begins when jaundice disappears, lasting weeks to months, major complaints include easy fatigability and persistent hepatomegaly
Recovery
- Most acute Hepatitis A patients fully recover without complications.
- Some cases of HBV and most HCV cases result in chronic hepatitis.
Complications
- Acute liver failure (potentially fatal) can be a complication.
- Fulminant hepatic failure: severe form of acute liver failure
- Encephalopathy, gastrointestinal bleeding, and disseminated intravascular coagulation are possible manifestations
- Chronic hepatitis B and C: are complications that can lead to cirrhosis, portal hypertension, and hepatocellular carcinoma.
- Other possible complications include cirrhosis, portal hypertension, and hepatocellular carcinoma
Diagnostic Studies
- HAV IgM, anti HAV IgG
- HBsAg, anti HBs, HBeAg, anti HBe, anti HBc IgM, anti HBc IgG, HBV DNA
- Anti HCV, HCV RNA
- Anti HDV, HDV Ag
- Liver function tests
- Viral genotype testing
- HBV
- HCV
- Physical assessment
- Liver biopsy
- FibroScan and/or FibroSure (FibroTest)
Case Study - Laboratory Results
- Hemoglobin 12 g/dL
- Bilirubin (direct) 5.6 mg/dL
- Bilirubin (indirect) 3.4 mg/dL
- Alkaline Phosphatase 600 U/mL
- AST 1200 U/mL
- ALT 1510 U/mL
- Urine positive for bilirubin
- Anti HAV IgM positive
- Anti HAV IgG negative
- HBsAg negative
- Anti HBs negative
- Anti HCV negative
- Anti HDV negative
Interprofessional Care
- Acute and chronic: Adequate nutrition, well-balanced diet, vitamin supplements, rest (with degree of strictness that varies per patient), avoid alcohol and drugs detoxified by the liver, notification of possible contacts
- Acute HAV, no specific drug therapy
- Acute HBV, drug therapy needed if severe
- Acute HCV, pegylated interferon or DAAs used. Supportive drug therapy, antihistamines & antiemetics
- Chronic Hepatitis B: decrease viral load, liver enzyme levels, disease progression, prevent complications (cirrhosis, portal hypertension, liver failure, cancer)
- Drug therapy needed for both hepatitis B and C infections (various drugs)
- Nutritional therapy: well balanced diet, adequate calorie intake in acute infections, vitamins (complex and K) may be important; fluid & electrolyte balance
Nursing Assessment
- Subjective data—medical history (including allergies, prior infection, current medications, habits), exposure to infected persons, ingested foods, blood transfusions, other risk factors
- Functional health patterns—iv drug & alcohol use, distaste for cigarettes (in smokers), high risk sexual behaviors, weight loss, anorexia, abdominal discomfort, change in urine/stool color, fatigue, arthralgias/myalgias, and exposure to high-risk groups
- Objective data—low-grade fever, jaundice, rash, hepatomegaly, splenomegaly, abnormal lab values/findings/results
Nursing Diagnoses
- Imbalanced nutrition less than body requirements
- Activity intolerance
- Risk for impaired liver function
Planning
- Patient will have relief of discomfort
- Resumption of normal activities
- Normal liver function without complications
Hepatitis Transmission Prevention
- Active immunization (vaccination)
- Post exposure prophylaxis (PEP) if exposure occurs in healthcare personnel
- General measures (avoiding contaminated food/water, proper hygiene, sanitation etc.)
Hepatitis A
- Etiology: Fecal oral route
- Pathophysiology: Primarily inflammation of liver tissue
- Mode of transmission: Fecal contamination and oral ingestion, especially in individuals in high-risk populations or outbreaks; found in the feces from 2 or more weeks before the onset of symptoms to up 1 week after the onset of jaundice
- Detection: Presence of HAV IgM antibodies are indicative of acute infection
- Clinical manifestations: Acute, mild/asymptomatic, including malaise, anorexia, fatigue, nausea, vomiting, right upper quadrant discomfort, jaundice, and possible low-grade fever
- Interventions: Adequate nutrition, comfort measures, assessment for Jaundice, comfort measures, physical rest & emotional rest, diversion activities
- Complications: Acute liver failure
Nursing Implementation and Evaluation
- Patient education and follow-up
- Avoidance of alcohol and hepatotoxic agents
Key entities
- HAV, IgG, IgM, HBV, HCV, HDV, HCV, liver cells, etc
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Description
Test your knowledge on Hepatitis A and B with this comprehensive quiz. Explore topics such as transmission, infection characteristics, and treatment options. Understand the preventative measures and clinical manifestations associated with these infections.