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Questions and Answers
What type of viruses are Hepatitis A and E classified as?
Which hepatitis virus requires the presence of another virus for its propagation?
What type of immune response is thought to cause liver damage in Hepatitis A infections?
Which form of Hepatitis B particle is considered the infectious form?
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What is a significant risk associated with Hepatitis C infections?
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In terms of hepatitis virus pathogenesis, what does Hepatitis B do to hepatocytes?
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What is the primary way to prevent the spread of viral hepatitis?
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Which hepatitis virus is primarily transmitted through contaminated water or food?
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What is the primary route of transmission for Hepatitis A?
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Which statement about the incubation period of Hepatitis E is true?
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What is a significant difference between Hepatitis B and Hepatitis C?
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Which population is most commonly affected by Hepatitis A in developed countries?
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What is a common source of infection for the genotype 3 of Hepatitis E?
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What is the primary method of transmission for Hepatitis B in high prevalence areas?
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What is the status of Hepatitis B surface antigen (HBsAg) in the provided serology results?
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Which symptom is NOT typically associated with the initial presentation of viral hepatitis?
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What clinical finding is often elevated in patients with hepatitis?
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In which case would Hepatitis C antibody (Anti-HCV) test result most likely remain positive?
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Which preventive measure is NOT associated with preventing Hepatitis A?
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What is a common route of parenteral transmission for blood-borne viruses like Hepatitis C?
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What is the recommended timing for administering passive immunization after exposure to Hepatitis A?
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Which group has the highest risk of symptomatic hepatitis A infection?
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For which group is pre-exposure vaccination against Hepatitis A recommended?
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What does a positive Hepatitis B e antigen (HBeAg) indicate?
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Which of the following serology results indicates an active Hepatitis C infection?
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Which of the following statements about hepatitis C is false?
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What constitutes a person whose Hepatitis C infection has been cleared?
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Which symptom commonly follows the prodromal symptoms of hepatitis?
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What is an appropriate treatment for Hepatitis A?
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What is the primary goal of antiviral therapy in chronic Hepatitis B infection?
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Which of the following is NOT a recommended strategy for preventing Hepatitis B?
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In what circumstances is passive immunization recommended?
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What type of infection does Hepatitis E generally lead to?
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What is a key component of chronic Hepatitis B patient education?
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What is indicated by a seroconversion of e antigen to e antibody in Hepatitis B management?
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Which group of individuals is classified as 'at risk' for severe Hepatitis-related complications?
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What is the recommended vaccination course for Hepatitis B?
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Study Notes
###Â Hepatitis
- Inflammation of the liver.
- Can be caused by infectious and non-infectious agents.
- Infectious agents include bacterial, viral and other as in parasites.
- Non-infectious agents include drugs, alcohol, vascular, autoimmune and metabolic causes.
Hepatitis A
- RNA virus belonging to enterovirus family (picornavirus).
- Human-specific virus shed in faeces.
- Transmission primarily through person-to-person contact via faecal-oral route.
- Also transmitted through contaminated food and water.
- Incubation period is 30 days (range 15-50).
- Period of infectiousness is 2 weeks before to 1 week after onset of symptoms.
- Worldwide prevalence is highest in developing countries with almost all children having antibodies to the virus indicating prior infection.
- In developed countries, it is most commonly seen in travellers to endemic countries, household or sexual contacts of known cases, men who have sex with men, and occasional foodborne outbreaks.
Hepatitis B
- DNA virus that infects hepatocytes.
- Expresses viral proteins on the surface of the cell.
- Triggers cellular immune response leading to liver damage.
- Three forms: Dane particle, spherical form and filaments.
- Incubation period is 1-6 months.
- Transmission occurs perinatally, sexually and parenterally.
- Vaccination is available and effective.
Hepatitis C
- RNA virus belonging to flavivirus family.
- At least 6 distinct genotypes exist (1-6) with no cross-protection.
- Incubation period is 8 weeks (average).
- Transmission occurs perinatally, sexually and parenterally.
- No vaccine available.
Hepatitis D
- Defective RNA virus, requiring Hepatitis B surface antigen for propagation.
- Incomplete viral particle.
Hepatitis E
- RNA virus with four genotypes, specific geographical distribution and epidemiology.
- Genotypes 1 and 2: Transmitted through faecally contaminated water in developing countries.
- Genotypes 3 and 4: Transmitted through contaminated food, particularly undercooked pork and shellfish, direct contact with pigs, and contaminated water.
- Incubation period is 30-40 days.
General Presentation of Hepatitis
- Patients present with symptoms/signs of hepatitis or complications of that viral infection.
- Symptoms include fever, loss of appetite, nausea, fatigue, right upper quadrant abdominal pain, dark urine, pale greasy stools, and jaundice.
- Abnormal liver function tests (LFTs) are common.
- Bilirubin levels increase.
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels increase.
Viral Hepatitis – Clinical Course
- Hepatitis A: Usually asymptomatic in children, risk of symptomatic infection increases with age.
- Fulminant disease (acute hepatitis failure) is unusual, with 6 months being the duration for a possible chronic infection.
- Hepatitis B: Serology results are used to assess the stage of infection.
Hepatitis B Serology Results
- HBsAg (surface antigen): Positive indicates current Hepatitis B infection, whether acute or chronic.
- Hep BeAg (e antigen): Detectable when the virus is actively reproducing, indicating infectivity.
- Hep Be Ab (e antibody): Positive indicates a past infection or current infection with low infectivity.
- Anti Hep B core IgM: Positive indicates a recent or current infection.
- Anti Hep B core total (IgG): Positive indicates a past or current infection, may be present for life.
- Anti HBs (surface antibody): Positive indicates immunity due to vaccination or prior infection.
Hepatitis C Laboratory Diagnosis
- Hepatitis C antibody (Anti-HCV): Usually positive 2-6 months after exposure to Hepatitis C, remains positive even if the infection is cleared.
- Hepatitis C antigen (HCV ag): Positive in acute and chronic infection.
- Hepatitis C virus (HCV) RNA: Positive in acute and chronic infection.
Hepatitis A Management
- Treatment is supportive care.
- Prevention is focused on hygiene, sanitation, and vaccination.
- Vaccination is recommended for travellers to endemic countries, individuals at risk of infection (e.g., chronic liver disease, injecting drug users, men who have sex with men).
Hepatitis E Management
- Usually self-limiting acute infection, requiring symptomatic treatment only.
- Chronic infection in transplant patients requires reducing immunosuppression and using antivirals.
Hepatitis B Management
- Acute infection requires supportive therapy.
- Chronic infection management includes:
- Patient education.
- Vaccination.
- Antiviral therapy, aiming to prevent progression to cirrhosis, liver failure, or cancer.
- Monitoring for liver cancer.
- Transplantation for fulminant hepatitis or end-stage chronic hepatitis.
Hepatitis B Prevention
- Strategy varies with high & low prevalence areas.
- Standard precautions include safe sex practices, screening blood products, using clean needles and disposable equipment, and practicing good hand hygiene.
- Passive immunisation with immunoglobulin (post-exposure prophylaxis) is recommended for newborns, those facing needle stick injuries, and individuals with inadequate antibodies after a high-risk exposure.
- Vaccination is recommended for high-risk groups and as part of national immunization programs.
Hepatitis C Management
- Treatment for acute infection is under review.
- No specific post-exposure prophylaxis is available.
Hepatitis C Prevention
- Focus on safe sex practices, screening blood products, using clean needles and disposable equipment, and practicing good hand hygiene.
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Description
Test your knowledge on hepatitis, its causes, and the specifics of hepatitis A and B. This quiz covers the infectious and non-infectious agents that lead to liver inflammation, along with transmission routes. Perfect for students and health enthusiasts.
