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Hepatitis: Causes, Symptoms, and Types
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Hepatitis: Causes, Symptoms, and Types

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@InnocuousWashington

Questions and Answers

What is the primary mechanism behind inflammation of the liver and liver damage in hepatitis?

  • Immune cells destroying infected hepatocytes (correct)
  • Hepatocytes multiplying abnormally
  • Toxic substances directly damaging liver cells
  • Liver cells producing excessive bilirubin

    • Which of the following is a characteristic of chronic hepatitis?

  • Complete recovery within 6 months
  • Progression to fibrosis and cirrhosis (correct)
  • Severe symptoms from the start
  • Immune system suppressing the virus

    • What is the most common cause of liver inflammation worldwide?

  • Viral hepatitis (correct)
  • Alcoholic hepatitis
  • Autoimmune hepatitis
  • Toxic/drug-induced hepatitis

    • What is the significance of HAV IgM in hepatitis A serology?

    <p>Indicates active infection</p> Signup and view all the answers

    What is the gold standard for diagnosing hepatitis C infection?

    <p>HCV RNA testing using PCR</p> Signup and view all the answers

    What is a common symptom of hepatitis?

    <p>Fever and malaise</p> Signup and view all the answers

    What is the significance of increased serum transaminases in hepatitis?

    <p>Indicates liver damage</p> Signup and view all the answers

    What is a common cause of hepatitis in newborns and children?

    <p>Giant cell hepatitis</p> Signup and view all the answers

    What is the mechanism of action of ribavirin?

    <p>Stopping viral RNA synthesis</p> Signup and view all the answers

    What is the brand name of the combination of sofosbuvir and ledipasvir?

    <p>Harvoni</p> Signup and view all the answers

    What is the primary treatment for hepatitis A?

    <p>Maintaining nutrition and hydration</p> Signup and view all the answers

    What is the contraindication for ribavirin?

    <p>Pregnancy</p> Signup and view all the answers

    What is the brand name of the combination of ombitasvir, paritaprevir, ritonavir, and dasabuvir?

    <p>Viekira Pak</p> Signup and view all the answers

    What is the mechanism of action of pegylated interferon?

    <p>Stimulating an immune response</p> Signup and view all the answers

    What is the brand name of telbivudine?

    <p>Tyzeka</p> Signup and view all the answers

    What is the effect of ribavirin on antiretroviral medications?

    <p>Interacts with some of them</p> Signup and view all the answers

    What is the indication for post-exposure prophylaxis for hepatitis A?

    <p>People who are not vaccinated within 2 weeks of exposure</p> Signup and view all the answers

    What is the brand name of the combination of elbasvir and grazoprevir?

    <p>Zepatier</p> Signup and view all the answers

    What is the primary location of inflammatory cells in the liver during hepatitis?

    <p>Tissue of liver</p> Signup and view all the answers

    Which of the following hepatitis types is often associated with heart failure?

    <p>Ischemic hepatitis</p> Signup and view all the answers

    What is the significance of atypical lymphocytosis in hepatitis?

    <p>Due to stimulation from viral antigens</p> Signup and view all the answers

    What is the significance of HCV RNA testing using PCR?

    <p>Can detect virus early, even 1-2 weeks after infection</p> Signup and view all the answers

    What is the significance of IgM anti-HBc in hepatitis B serology?

    <p>Indicates active infection</p> Signup and view all the answers

    What is the common outcome of chronic hepatitis?

    <p>Progression to fibrosis and cirrhosis</p> Signup and view all the answers

    What is the significance of jaundice in hepatitis?

    <p>Due to increased bilirubin in the blood</p> Signup and view all the answers

    What is the significance of hepatomegaly in hepatitis?

    <p>Due to inflammation of the liver</p> Signup and view all the answers

    What is the common association of non-alcoholic fatty liver disease?

    <p>Diabetes mellitus and metabolic syndrome</p> Signup and view all the answers

    What is the common characteristic of acute hepatitis B infection?

    <p>HBsAg (+), total anti-HBc (+), and IgM anti-HBc (+)</p> Signup and view all the answers

    What is the mechanism of action of Sofosbuvir?

    <p>Anti-HCV RNA polymerase inhibitor</p> Signup and view all the answers

    What is the brand name of the combination of Sofosbuvir and Ledipasvir?

    <p>Harvoni</p> Signup and view all the answers

    What is the effect of Ribavirin on Antiretroviral medications?

    <p>Interacts with some Antiretroviral medications, such as AZT and didanosine</p> Signup and view all the answers

    What is the primary treatment for Chronic HCV infection?

    <p>Antiviral medications, including Sofosbuvir and Ribavirin</p> Signup and view all the answers

    What is the brand name of the combination of Ombitasvir, Paritaprevir, Ritonavir, and Dasabuvir?

    <p>Viekira Pak</p> Signup and view all the answers

    What is the contraindication for Ribavirin?

    <p>Pregnancy</p> Signup and view all the answers

    What is the brand name of Telbivudine?

    <p>Tyzeka</p> Signup and view all the answers

    What is the mechanism of action of Pegylated Interferon?

    <p>Protein released in the body in response to viral infections</p> Signup and view all the answers

    What is the indication for post-exposure prophylaxis for Hepatitis A?

    <p>People within 2 weeks of exposure who are not vaccinated</p> Signup and view all the answers

    What is the effectiveness of Sofosbuvir with Ribavirin and Interferon in people with genotype 1, 4, 5, or 6?

    <p>90%</p> Signup and view all the answers

    Study Notes

    Defining Hepatitis

    • Inflammation of the liver characterized by inflammatory cells in liver tissue
    • Often leads to jaundice, poor appetite, and malaise
    • Can be acute (< 6 months) or chronic (> 6 months)

    Chronic Hepatitis

    • May have no initial symptoms
    • Progresses to fibrosis (scarring) and cirrhosis (chronic liver failure)
    • Increases risk of hepatocellular carcinoma

    Causes of Hepatitis

    • Viral hepatitis (most common cause of liver inflammation worldwide)
    • Alcoholic hepatitis
    • Toxic/drug-induced hepatitis
    • Autoimmune hepatitis
    • Non-alcoholic fatty liver disease (often associated with diabetes and metabolic syndrome)
    • Ischemic hepatitis (often associated with heart failure)
    • Giant cell hepatitis (rare, affecting newborns and children)

    Pathophysiology

    • Viruses target hepatocytes, causing them to express abnormal proteins on their surface
    • Immune cells destroy infected hepatocytes, leading to inflammation and liver damage

    Symptomatology

    • Fever, malaise, and nausea due to immune system response
    • Hepatomegaly and leaking transaminases into blood cause increased serum transaminases (ALT > AST)
    • Atypical lymphocytosis common due to stimulation from viral antigens
    • Jaundice, increased bilirubin (conjugated and unconjugated), and increased urobilinogenuria

    HAV Serology

    • HAV IgM indicates active infection
    • HAV IgG indicates protective antibody, recovery, or previous vaccination

    HCV Serology

    • HCV RNA testing using PCR is the gold standard, detecting virus early (1-2 weeks after infection)
    • Detects levels of viral RNA in the blood, indicating recovery or chronic infection

    Acute Hepatitis B Infection

    • HBsAg (+)
    • Total anti-HBc (+)
    • IgM anti-HBc (+)
    • Anti-HBs (-)

    Treatment of Hepatitis

    • Treating HAV: maintain nutrition and hydration, practice personal hygiene, and provide post-exposure prophylaxis to unvaccinated individuals within 2 weeks of exposure
    • Treating HCV: antiviral medications recommended for all people with proven chronic HCV not at high risk of dying from other causes
    • Treating HBV: various medications including lamivudine, adefovir, entecavir, telbivudine, tenofovir, and peginterferon

    New Anti-HCV Drugs

    • Sofosbuvir (Sovaldi): anti-HCV RNA polymerase inhibitor with high cure rate and fewer adverse effects
    • Ledipasvir (Harvoni): inhibitor of HCV NS5A protein, well tolerated with minimal side effects
    • Ombitasvir/paritaprevir/ritonavir + dasabuvir (Viekira Pak): combination therapy for genotype 1
    • Elbasvir + grazoprevir (Zepatier): once-a-day combo pill for genotypes 1 or 4

    Effectiveness of Treatment

    • Sofosbuvir with ribavirin and interferon: 90% effective in genotypes 1, 4, 5, or 6
    • Sofosbuvir with just ribavirin: 70-95% effective in genotypes 2 and 3
    • Ledipasvir (Harvoni): 93-99% effective in genotype 1, but expensive
    • Ribavirin and peginterferon: 60-90% effective in genotype 6

    Defining Hepatitis

    • Inflammation of the liver characterized by inflammatory cells in liver tissue
    • Often leads to jaundice, poor appetite, and malaise
    • Can be acute (< 6 months) or chronic (> 6 months)

    Chronic Hepatitis

    • May have no initial symptoms
    • Progresses to fibrosis (scarring) and cirrhosis (chronic liver failure)
    • Increases risk of hepatocellular carcinoma

    Causes of Hepatitis

    • Viral hepatitis (most common cause of liver inflammation worldwide)
    • Alcoholic hepatitis
    • Toxic/drug-induced hepatitis
    • Autoimmune hepatitis
    • Non-alcoholic fatty liver disease (often associated with diabetes and metabolic syndrome)
    • Ischemic hepatitis (often associated with heart failure)
    • Giant cell hepatitis (rare, affecting newborns and children)

    Pathophysiology

    • Viruses target hepatocytes, causing them to express abnormal proteins on their surface
    • Immune cells destroy infected hepatocytes, leading to inflammation and liver damage

    Symptomatology

    • Fever, malaise, and nausea due to immune system response
    • Hepatomegaly and leaking transaminases into blood cause increased serum transaminases (ALT > AST)
    • Atypical lymphocytosis common due to stimulation from viral antigens
    • Jaundice, increased bilirubin (conjugated and unconjugated), and increased urobilinogenuria

    HAV Serology

    • HAV IgM indicates active infection
    • HAV IgG indicates protective antibody, recovery, or previous vaccination

    HCV Serology

    • HCV RNA testing using PCR is the gold standard, detecting virus early (1-2 weeks after infection)
    • Detects levels of viral RNA in the blood, indicating recovery or chronic infection

    Acute Hepatitis B Infection

    • HBsAg (+)
    • Total anti-HBc (+)
    • IgM anti-HBc (+)
    • Anti-HBs (-)

    Treatment of Hepatitis

    • Treating HAV: maintain nutrition and hydration, practice personal hygiene, and provide post-exposure prophylaxis to unvaccinated individuals within 2 weeks of exposure
    • Treating HCV: antiviral medications recommended for all people with proven chronic HCV not at high risk of dying from other causes
    • Treating HBV: various medications including lamivudine, adefovir, entecavir, telbivudine, tenofovir, and peginterferon

    New Anti-HCV Drugs

    • Sofosbuvir (Sovaldi): anti-HCV RNA polymerase inhibitor with high cure rate and fewer adverse effects
    • Ledipasvir (Harvoni): inhibitor of HCV NS5A protein, well tolerated with minimal side effects
    • Ombitasvir/paritaprevir/ritonavir + dasabuvir (Viekira Pak): combination therapy for genotype 1
    • Elbasvir + grazoprevir (Zepatier): once-a-day combo pill for genotypes 1 or 4

    Effectiveness of Treatment

    • Sofosbuvir with ribavirin and interferon: 90% effective in genotypes 1, 4, 5, or 6
    • Sofosbuvir with just ribavirin: 70-95% effective in genotypes 2 and 3
    • Ledipasvir (Harvoni): 93-99% effective in genotype 1, but expensive
    • Ribavirin and peginterferon: 60-90% effective in genotype 6

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    Description

    This quiz covers the definition, types, and causes of hepatitis, a liver disease characterized by inflammation and potentially leading to chronic liver failure and cancer.

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