11. Hepatitis Overview and Viruses

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Questions and Answers

Which of the following is NOT a typical mode of transmission for Hepatitis A?

  • Close contact with an infected individual
  • Sharing needles (correct)
  • Consuming contaminated food
  • Consuming contaminated water

A patient presents with jaundice, dark urine, and pale stools. Which phase of acute hepatitis is most likely?

  • Pre-icteric phase
  • Post-icteric phase
  • Icteric phase (correct)
  • Recovery phase

A patient has a past Hepatitis B infection, but is not currently infected. Which serological marker would be present?

  • HBsAg
  • HBeAg
  • Anti-HBs (correct)
  • Anti-HBc IgM

Which of the following statements correctly describes Hepatitis D?

<p>It requires a concurrent Hepatitis B infection to replicate. (A)</p> Signup and view all the answers

A liver biopsy of a patient with chronic hepatitis shows fibrosis and liver dysfunction. This would be characterized as:

<p>Cirrhosis (A)</p> Signup and view all the answers

Which of the following complications is most associated with chronic Hepatitis C infection?

<p>Increased risk of B-cell Non-Hodgkin Lymphoma. (A)</p> Signup and view all the answers

Which of the following lab findings is associated with active viral replication in Hepatitis B infection?

<p>HBeAg (B)</p> Signup and view all the answers

Which of these is characteristic of acute Hepatitis?

<p>Can be self-limiting with no chronic infection (B)</p> Signup and view all the answers

Which of the following is a significant risk factor for contracting Hepatitis E?

<p>Contaminated water (B)</p> Signup and view all the answers

Which of these is NOT a non-viral cause of Hepatitis?

<p>Hepatitis B virus (B)</p> Signup and view all the answers

A patient in the icteric phase of acute hepatitis would most likely exhibit which set of symptoms?

<p>Jaundice, dark urine, and pale stools. (C)</p> Signup and view all the answers

In a patient with chronic hepatitis, what clinical manifestation is most suggestive of advanced disease?

<p>Jaundice and right upper quadrant pain. (D)</p> Signup and view all the answers

Which laboratory finding is most indicative of liver damage associated with hepatitis?

<p>Elevated aminotransferases (ALT, AST). (A)</p> Signup and view all the answers

A patient is diagnosed with fulminant hepatitis. Which of the following clinical findings would be most expected?

<p>Rapid development of liver failure and encephalopathy. (A)</p> Signup and view all the answers

The presence of anti-HAV IgG in a patient's serological test indicates what regarding Hepatitis A?

<p>Past infection with or immunity to Hepatitis A. (A)</p> Signup and view all the answers

Which hepatitis virus requires a co-infection with another specific hepatitis virus to replicate?

<p>Hepatitis D virus (HDV) (B)</p> Signup and view all the answers

Which of the following is the most common route of transmission for Hepatitis C?

<p>Intravenous drug use and blood transfusions (A)</p> Signup and view all the answers

Which of the following is a known non-viral cause of hepatitis listed in the text?

<p>Chronic alcohol consumption (C)</p> Signup and view all the answers

A patient diagnosed with hepatitis has symptoms lasting approximately two months. How would this be categorized?

<p>Acute hepatitis (B)</p> Signup and view all the answers

Which of the following is a common mode of transmission for Hepatitis A?

<p>Fecal-oral transmission (B)</p> Signup and view all the answers

Which of the hepatitis viruses is particularly severe in pregnant women?

<p>Hepatitis E virus (HEV) (B)</p> Signup and view all the answers

Which hepatitis virus is commonly acquired through blood transfusions?

<p>HCV (D)</p> Signup and view all the answers

Which mode of transmission is most associated with the Hepatitis B virus?

<p>Bloodborne, sexual or perinatal transmission (B)</p> Signup and view all the answers

Which type of hepatitis is characterized by its ability to integrate into the host's genome?

<p>Hepatitis B (C)</p> Signup and view all the answers

A patient recently traveled to an area with poor sanitation. Which is the most likely form of hepatitis they would be at risk for?

<p>Hepatitis A (A)</p> Signup and view all the answers

Which route of transmission is most commonly associated with Hepatitis C?

<p>Sharing of needles (D)</p> Signup and view all the answers

A patient develops chronic hepatitis, leading to liver fibrosis and cirrhosis. Which virus is most likely to cause this progression?

<p>Hepatitis C (D)</p> Signup and view all the answers

Which type of hepatitis commonly results in cytopathic damage within the liver but is usually self-limiting?

<p>Hepatitis A (C)</p> Signup and view all the answers

A patient reports a history of receiving blood products prior to 1992. What is the most relevant risk factor for their current liver issues?

<p>Exposure to Hepatitis C (A)</p> Signup and view all the answers

Which of the following is an autoimmune condition that can lead to hepatitis?

<p>Autoimmune hepatitis (D)</p> Signup and view all the answers

Which of the following is NOT a common risk factor for Hepatitis B?

<p>Receiving blood transfusions pre-1992 (D)</p> Signup and view all the answers

Which serological marker indicates a recent Hepatitis B infection?

<p>Anti-HBc IgM (C)</p> Signup and view all the answers

What is the primary confirmatory test for Hepatitis C?

<p>HCV RNA PCR (B)</p> Signup and view all the answers

Which treatment approach has demonstrated high cure rates for Hepatitis C?

<p>Direct-Acting Antivirals (A)</p> Signup and view all the answers

In managing ascites due to cirrhosis, which of the following is a typical intervention?

<p>Diuretics and paracentesis (A)</p> Signup and view all the answers

Which serological marker suggests that a person has lower infectivity of Hepatitis B?

<p>Anti-HBe (D)</p> Signup and view all the answers

What is a primary intervention to prevent encephalopathy in patients with cirrhosis?

<p>Lactulose (B)</p> Signup and view all the answers

A patient is found to have active viral Hepatitis B replication. Which serological marker would be present?

<p>HBeAg (A)</p> Signup and view all the answers

Which of the following is NOT typically included in the general treatment measures for hepatitis?

<p>Alcohol consumption (B)</p> Signup and view all the answers

Flashcards

What is Hepatitis?

Inflammation of the liver, potentially impairing its function.

What is acute Hepatitis?

Hepatitis caused by a virus and lasting for less than 6 months.

What is chronic Hepatitis?

Hepatitis caused by a virus and lasting for more than 6 months.

What is Hepatitis A?

Infection with Hepatitis A virus, typically spread through contaminated food or water.

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What is Hepatitis B?

Infection with Hepatitis B virus, often spread through blood or sexual contact.

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What is Hepatitis C?

Infection with Hepatitis C virus, primarily transmitted through contaminated blood.

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What is Hepatitis D?

Infection with Hepatitis D virus, which requires co-infection with Hepatitis B.

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What is Hepatitis E?

Infection with Hepatitis E virus, usually spread through contaminated water.

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What is alcoholic Hepatitis?

Liver damage caused by excessive alcohol consumption.

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What is drug-induced Hepatitis?

Liver damage caused by drugs or toxins.

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Define Acute Hepatitis

Hepatitis caused by a virus and lasting for less than 6 months.

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Define Chronic Hepatitis

Hepatitis caused by a virus and lasting for more than 6 months.

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Pre-icteric Phase

A phase of acute hepatitis characterized by general flu-like symptoms, loss of appetite, nausea, vomiting, tiredness, and abdominal discomfort.

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Icteric phase

A phase of acute hepatitis marked by yellowing of the skin, dark urine, pale stools, enlarged liver, and itching.

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Fulminant Hepatitis

A severe complication of hepatitis characterized by rapid liver failure, brain dysfunction, impaired blood clotting, and a high risk of death.

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Cirrhosis

Progressive scarring of the liver leading to impaired liver function, increased pressure in the portal vein, bleeding from enlarged veins in the esophagus, and fluid accumulation in the abdomen.

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Hepatocellular Carcinoma (HCC)

A type of cancer that develops in the liver, primarily associated with chronic hepatitis B or C infection. It often presents in late stages with a poor prognosis.

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How is Hepatitis A spread?

Hepatitis A is most commonly spread through contaminated food or water.

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How is Hepatitis B spread?

Hepatitis B is often transmitted through blood, sexual contact, or from mother to child during birth.

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How is Hepatitis C spread?

Hepatitis C is primarily spread through contaminated blood, often shared needles or unsanitary medical practices.

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How is Hepatitis D spread?

Hepatitis D requires co-infection with Hepatitis B to spread. It can be transmitted through blood contact, like shared needles.

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How is Hepatitis E spread?

Hepatitis E is commonly spread through contaminated water, especially in areas with poor sanitation, and sometimes through undercooked meat.

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What is the typical course of Hepatitis A?

HAV infection often leads to a self-limiting illness, meaning it usually resolves on its own without causing chronic disease.

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Why can Hepatitis B become chronic?

HBV can lead to chronic infection because the virus integrates into the host's DNA, potentially evading the immune system.

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Why can Hepatitis C become chronic?

HCV often causes chronic infection because the virus mutates quickly, making it difficult for the immune system to eliminate.

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What is HBsAg Test?

A blood test that detects the presence of hepatitis B surface antigen (HBsAg), indicating active infection.

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What is Anti-HBs Test?

Detects antibodies against hepatitis B surface antigen (HBsAg), indicating immunity or previous infection.

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What is HBeAg Test?

A blood test that detects hepatitis B e antigen (HBeAg), indicating active viral replication.

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What is Anti-HBe Test?

A blood test that detects antibodies against hepatitis B e antigen (HBeAg), indicating lower infectivity.

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What is Anti-HBc IgM Test?

Detects antibodies against hepatitis B core antigen (HBcAg), indicating a recent infection.

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What is Anti-HBc IgG Test?

Detects antibodies against hepatitis B core antigen (HBcAg), indicating past or chronic infection.

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What is Anti-HCV Antibody Test?

A blood test that detects antibodies against hepatitis C virus (HCV), used for initial screening.

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What is HCV RNA PCR?

A test that detects hepatitis C virus (HCV) RNA in the blood, used for confirmation and measuring viral load.

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Study Notes

Hepatitis Overview

  • Hepatitis is liver inflammation, potentially impairing liver function.
  • Types: acute (<6 months) or chronic (>6 months).
  • Causes: various infectious viruses and non-infectious agents.
  • Five main viral types: A, B, C, D, E.

Viral Hepatitis Etiology

Hepatitis A Virus (HAV)

  • Transmission: fecal-oral route, poor sanitation.
  • Risk factors: travel to endemic areas, close contact, contaminated food/water.
  • Pathogenesis: infects hepatocytes, replicates, causes cell damage. Self-limiting, usually doesn't become chronic.

Hepatitis B Virus (HBV)

  • Transmission: bloodborne, sexual, perinatal.
  • Risk factors: unprotected sex, needle sharing, birth from infected mother, healthcare exposure.
  • Pathogenesis: DNA virus, integrates into host genome; chronic infection possible due to immune tolerance.

Hepatitis C Virus (HCV)

  • Transmission: bloodborne, IV drug use, blood transfusions.
  • Risk factors: needle sharing, pre-1992 blood products, unsterilized equipment, tattoos/piercings.
  • Pathogenesis: RNA virus, high mutation rate, evades immune response; chronic leading to fibrosis and cirrhosis.

Hepatitis D Virus (HDV)

  • Transmission: bloodborne, requires concurrent HBV infection for replication.
  • Risk factors: HBV co-infection, IV drug use, blood transfusions.

Hepatitis E Virus (HEV)

  • Transmission: fecal-oral, common in developing countries, severe in pregnant women.
  • Risk factors: contaminated water, undercooked meat, zoonotic transmission

Non-Viral Hepatitis Etiology

  • Alcohol: chronic consumption leads to alcoholic hepatitis.
  • Drugs/toxins: acetaminophen overdose, certain antibiotics, herbal supplements.
  • Autoimmune disease: autoimmune hepatitis (body attacks liver cells).

Clinical Manifestations

Acute Hepatitis

  • Pre-icteric phase: flu-like symptoms (anorexia, nausea, vomiting, fatigue, abdominal pain).
  • Icteric phase: jaundice, dark urine, pale stools, hepatomegaly, pruritus.

Chronic Hepatitis

  • Often asymptomatic until advanced stages. Symptoms include: fatigue, right upper quadrant pain, joint pain, and jaundice.

Other Manifestations

  • HBV: aplastic anemia, glomerulonephritis, vasculitis
  • HCV: mixed cryoglobulinemia, increased risk B-cell lymphoma, ITP, autoimmune hemolytic anemia, glomerulonephritis, vasculitis, porphyria cutanea tarda, lichen planus, increased risk diabetes, thyroiditis.

Complications

  • Fulminant Hepatitis: rapid liver failure, encephalopathy, coagulopathy, high mortality.
  • Cirrhosis: chronic liver damage, fibrosis, portal hypertension, variceal bleeding, ascites.
  • Hepatocellular Carcinoma (HCC): increased risk with chronic HBV and HCV infections (often advanced, poor prognosis).

Diagnosis

  • Liver function tests (LFTs): elevated aminotransferases (ALT, AST).
  • Elevated bilirubin, abnormal alkaline phosphatase, GGT.
  • Serological tests (specific for each virus type): IgM/IgG antibodies, antigens.

Treatment

  • General: supportive care (rest, diet, hydration). Avoid alcohol/hepatotoxic drugs.
  • Specific: varies by virus type (antivirals, direct-acting antivirals).

Managing Complications

  • Cirrhosis: monitor for varices, manage ascites, prevent encephalopathy, liver transplant.
  • HCC: surgical resection, liver transplant, ablation, chemoembolization, systemic therapies.

Prevention

  • General: hygiene, safe food/water consumption.
  • Safe practices: condoms, needle exchange, safe injection practices in healthcare settings.
  • Vaccines for HAV and HBV (routine childhood immunization).

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