Questions and Answers
What is the primary mechanism behind inflammation of the liver and liver damage in hepatitis?
Which of the following is a characteristic of chronic hepatitis?
What is the most common cause of liver inflammation worldwide?
What is the significance of HAV IgM in hepatitis A serology?
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What is the gold standard for diagnosing hepatitis C infection?
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What is a common symptom of hepatitis?
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What is the significance of increased serum transaminases in hepatitis?
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What is a common cause of hepatitis in newborns and children?
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What is the mechanism of action of ribavirin?
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What is the brand name of the combination of sofosbuvir and ledipasvir?
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What is the primary treatment for hepatitis A?
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What is the contraindication for ribavirin?
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What is the brand name of the combination of ombitasvir, paritaprevir, ritonavir, and dasabuvir?
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What is the mechanism of action of pegylated interferon?
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What is the brand name of telbivudine?
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What is the effect of ribavirin on antiretroviral medications?
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What is the indication for post-exposure prophylaxis for hepatitis A?
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What is the brand name of the combination of elbasvir and grazoprevir?
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What is the primary location of inflammatory cells in the liver during hepatitis?
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Which of the following hepatitis types is often associated with heart failure?
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What is the significance of atypical lymphocytosis in hepatitis?
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What is the significance of HCV RNA testing using PCR?
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What is the significance of IgM anti-HBc in hepatitis B serology?
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What is the common outcome of chronic hepatitis?
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What is the significance of jaundice in hepatitis?
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What is the significance of hepatomegaly in hepatitis?
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What is the common association of non-alcoholic fatty liver disease?
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What is the common characteristic of acute hepatitis B infection?
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What is the mechanism of action of Sofosbuvir?
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What is the brand name of the combination of Sofosbuvir and Ledipasvir?
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What is the effect of Ribavirin on Antiretroviral medications?
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What is the primary treatment for Chronic HCV infection?
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What is the brand name of the combination of Ombitasvir, Paritaprevir, Ritonavir, and Dasabuvir?
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What is the contraindication for Ribavirin?
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What is the brand name of Telbivudine?
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What is the mechanism of action of Pegylated Interferon?
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What is the indication for post-exposure prophylaxis for Hepatitis A?
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What is the effectiveness of Sofosbuvir with Ribavirin and Interferon in people with genotype 1, 4, 5, or 6?
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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.