Hepatitis Overview Quiz
68 Questions
2 Views

Hepatitis Overview Quiz

Created by
@FormidablePennywhistle

Podcast Beta

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which mode of transmission is primarily associated with Hepatitis A?

  • Vector-borne transmission
  • Parenteral transmission
  • Airborne transmission
  • Faecal-oral transmission (correct)

    • What type of necrosis is typically observed in acute viral hepatitis?

  • Central necrosis only
  • Confluent bridging necrosis (correct)
  • Only minor necrosis
  • Apoptotic necrosis only

    • Which statement regarding Hepatitis A is true?

  • It is primarily spread through infected blood.
  • Jaundice can be prolonged in some cases. (correct)
  • It can cause a chronic carrier state.
  • Symptomatic infection is more common in children.

    • What immunological marker indicates a recent infection with Hepatitis A?

    <p>IgM anti-HAV</p> Signup and view all the answers

    Which of the following is NOT a characteristic of Hepatitis A?

    <p>Chronic disease can develop.</p> Signup and view all the answers

    Which laboratory finding is typically associated with chronic hepatitis?

    <p>High AST/ALT levels</p> Signup and view all the answers

    What is a common symptom that may lead to the investigation of chronic hepatitis?

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

    Which condition is NOT categorized under chronic hepatitis?

    <p>Alcohol-related liver disease</p> Signup and view all the answers

    Which assessment is used to determine the stage of fibrosis in chronic hepatitis?

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

    Which of the following is a recognized cause of chronic hepatitis?

    <p>Chronic drug hepatitis</p> Signup and view all the answers

    What is the primary aim of treating chronic hepatitis?

    <p>Delay progression to cirrhosis</p> Signup and view all the answers

    What does piecemeal necrosis indicate in the context of chronic hepatitis?

    <p>Chronic damage with inflammatory response</p> Signup and view all the answers

    Which of the following describes a typical presentation of chronic hepatitis?

    <p>Routine health check revealing abnormal LFTs</p> Signup and view all the answers

    What is the primary inflammatory cell involved in hepatitis, regardless of its duration?

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

    Which of the following diseases is known to cause only acute hepatitis?

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

    Which factor can influence the progression from acute hepatitis B virus (HBV) to chronic hepatitis?

    <p>Age of infection</p> Signup and view all the answers

    Which condition is NOT classified under conventional chronic hepatitis?

    <p>Alcohol-related liver disease</p> Signup and view all the answers

    What is a common consequence of severe acute hepatitis?

    <p>Acute liver failure</p> Signup and view all the answers

    Which of the following is a cause of chronic liver damage that does not fall under chronic hepatitis?

    <p>Non-alcoholic fatty liver disease</p> Signup and view all the answers

    Which hepatitis virus is most likely to progress to chronic infection?

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

    What are the typical vague symptoms of acute hepatitis?

    <p>Nausea, anorexia, and malaise</p> Signup and view all the answers

    What histological finding is least likely to be associated with mild chronic hepatitis C?

    <p>Fibrous tissue proliferation</p> Signup and view all the answers

    Which extrahepatic manifestation is commonly associated with hepatitis C?

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

    Which genotype of hepatitis C is most prevalent in Europe?

    <p>Type 1b</p> Signup and view all the answers

    What describes the typical risk of cirrhosis development over the course of chronic hepatitis C?

    <p>20% over 20 years</p> Signup and view all the answers

    What is a method previously used to guide treatment based on histological damage in chronic hepatitis C?

    <p>Biopsy assessment</p> Signup and view all the answers

    What is the primary cause of acute liver failure (ALF) in South Asia?

    <p>Hepatitis E virus</p> Signup and view all the answers

    What factor increases the risk of more serious disease from Hepatitis E?

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

    Which of the following statements about Hepatitis B is accurate?

    <p>Chronic HBV disease affects approximately 300 million worldwide.</p> Signup and view all the answers

    What is required for the replication of the Hepatitis D virus?

    <p>Presence of Hepatitis B virus</p> Signup and view all the answers

    Which of the following best describes the typical progression of Hepatitis C infection?

    <p>Most cases progress to chronic infection (&gt;80%).</p> Signup and view all the answers

    What does the presence of anti-HCV antibodies indicate?

    <p>Exposure to Hepatitis C virus.</p> Signup and view all the answers

    In which population is Hepatitis D most commonly found?

    <p>Intravenous drug users (IDUs)</p> Signup and view all the answers

    What is a notable characteristic of Hepatitis C compared to other hepatitis viruses?

    <p>It is often asymptomatic during acute infection.</p> Signup and view all the answers

    What is the main characteristic of acute hepatitis as observed histologically?

    <p>Spotty focal necrosis of individual hepatocytes</p> Signup and view all the answers

    In Hepatitis A infections, which of the following is true regarding its common transmission scenarios?

    <p>Contaminated water or shellfish can lead to outbreaks.</p> Signup and view all the answers

    What is the significance of IgM anti-HAV in a patient suspected of Hepatitis A?

    <p>It confirms a recent acute infection.</p> Signup and view all the answers

    Which viral hepatitis is most likely to result in a chronic state following infection?

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

    What histological feature is frequently observed in acute hepatitis cases?

    <p>Cholestasis with significant periportal inflammation</p> Signup and view all the answers

    Which diseases are classified as causing chronic hepatitis?

    <p>Wilson’s disease and autoimmune hepatitis</p> Signup and view all the answers

    Which statement correctly describes the relationship between hepatitis viruses and their potential for chronic infection?

    <p>HBV has a high likelihood of becoming chronic depending on age.</p> Signup and view all the answers

    What are common symptoms experienced by patients with acute hepatitis?

    <p>Nausea, anorexia, and malaise</p> Signup and view all the answers

    Which of the following is a distinct characteristic of flares in chronic hepatitis?

    <p>They can mimic acute hepatitis.</p> Signup and view all the answers

    What is a significant consequence of severe acute hepatitis?

    <p>Acute liver failure</p> Signup and view all the answers

    What role does inflammation play in hepatitis diagnosis?

    <p>Inflammation is crucial regardless of hepatitis duration.</p> Signup and view all the answers

    Which type of hepatitis is known to rarely lead to acute liver failure?

    <p>Hepatitis E virus-related hepatitis</p> Signup and view all the answers

    What are the distinctive features of liver diseases not included in conventional chronic hepatitis?

    <p>They have unique inflammatory profiles.</p> Signup and view all the answers

    What is the typical duration for persistent abnormality to classify as chronic hepatitis?

    <p>More than 6 months</p> Signup and view all the answers

    Which of the following is an indicator of potential chronic hepatocellular damage?

    <p>Viral load of HBV or HCV</p> Signup and view all the answers

    Which of the following results from chronic hepatitis might signal an increase in the risk of hepatocellular carcinoma (HCC)?

    <p>Significant liver fibrosis</p> Signup and view all the answers

    Which of the following conditions is always classified as chronic hepatitis?

    <p>Auto-immune hepatitis</p> Signup and view all the answers

    What non-invasive technique is utilized for assessing fibrosis in chronic hepatitis?

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

    What type of inflammation is typically observed in chronic hepatitis?

    <p>Interface inflammation with piecemeal necrosis</p> Signup and view all the answers

    Which of the following is a common symptom indicating the need for chronic hepatitis investigation?

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

    In the assessment of chronic hepatitis, which scoring system helps in guiding prognosis and treatment?

    <p>Child-Pugh score</p> Signup and view all the answers

    What is a common extrahepatic manifestation associated with Hepatitis C?

    <p>Cryoglobulinaemia plus glomerulonephritis</p> Signup and view all the answers

    Which factor is NOT associated with an increased risk of progression in chronic Hepatitis C?

    <p>Family history of hypertension</p> Signup and view all the answers

    What is the primary genotype of Hepatitis C that shows the least response to interferon treatment?

    <p>Type 1a</p> Signup and view all the answers

    What histological finding is characteristic of mild chronic hepatitis?

    <p>Bile duct infiltration by lymphocytes</p> Signup and view all the answers

    What is a sustained virological response (SVR) a determinant of in patients with Hepatitis C?

    <p>Lower risk of cirrhosis and HCC progression</p> Signup and view all the answers

    What is the primary characteristic that differentiates Hepatitis D from other hepatitis viruses?

    <p>It requires the presence of Hepatitis B virus for replication.</p> Signup and view all the answers

    Which population is at the highest risk of developing serious disease from Hepatitis E?

    <p>Pregnant women</p> Signup and view all the answers

    Which statement best explains the prevalence of Hepatitis B globally?

    <p>It can range from 0.1% to over 10% depending on geographical location.</p> Signup and view all the answers

    What is the common progression of infection for most individuals who contract Hepatitis C?

    <p>More than 80% progress to chronic infection.</p> Signup and view all the answers

    What is a defining feature of Hepatitis A infections compared to other hepatitis viruses?

    <p>Most infections are subclinical or mild.</p> Signup and view all the answers

    Which of the following best describes the relationship between Hepatitis B and chronic disease?

    <p>Up to 30% of chronic HBV patients may develop cirrhosis or liver cancer.</p> Signup and view all the answers

    Which test confirms ongoing Hepatitis C infection more definitively than serology alone?

    <p>HCV RNA test in blood</p> Signup and view all the answers

    What is the relationship between Hepatitis E and water-borne outbreaks?

    <p>Hepatitis E mainly occurs in developing countries with inadequate water supply.</p> Signup and view all the answers

    Study Notes

    Hepatitis

    • Acute hepatitis: Abnormal liver function lasting less than 6 months.
    • Chronic hepatitis: Persistent liver abnormality for more than 6 months.
    • Hepatotropic viruses: Viruses that specifically target the liver, like Hepatitis A, B, C, and E.
    • Causes of Acute Hepatitis:
      • Viral infections (HAV, HBV, HCV, HEV, EBV, CMV, rubella)
      • Drugs
      • Rare: Acute liver failure
    • Signs of Acute Hepatitis:
      • Enlarged and tender liver
      • Jaundice (yellowing of the skin) may occur, especially in adults
      • Blood tests: High AST/ALT (liver enzymes), elevated bilirubin, normal albumin, prolonged PT (prothrombin time).
    • Causes of Chronic Hepatitis:
      • Chronic viral hepatitis (B, C, B+D or unknown)
      • Chronic drug hepatitis (rare)
      • Auto-immune hepatitis (always chronic)
      • Wilson’s disease (very rare, always chronic)
      • Alpha-1-antitrypsin deficiency (very rare)
    • Assessment of Chronic Hepatitis:
      • Blood tests: ALT/AST levels.
      • Viral load (e.g., HBV, HCV) or genotype (HCV).
      • Liver biopsy: Determines the "grade" of inflammation and the "stage" of fibrosis (from normal to cirrhosis).
      • Non-invasive assessments like FibroScan to assess fibrosis.
    • Chronic Liver Diseases Not Classified as Chronic Hepatitis:
      • Alcohol-related liver disease
      • Non-alcoholic fatty liver disease (NAFLD)
      • Chronic inflammatory biliary tract diseases (PBC, PSC)
      • Hereditary haemochromatosis

    Hepatitis A

    • Transmission: Faecal-oral route, commonly through contaminated water, food, or personal contact.
    • Clinical Features:
      • Usually subclinical or mild illness.
      • More symptomatic in adults (jaundice, fever)
      • Silent infection in childhood is common.
      • Rarely causes acute liver failure (ALF)
    • No chronic state or carrier state.
    • Lifelong immunity develops after contracting the virus, with IgM anti-HAV indicating an acute infection.
    • Vaccination: Available for protection.
    • Histology:
      • Periportal inflammation with plasma cells
      • Cholestasis
      • Acidophil bodies, apoptosis, “councilman body"

    Hepatitis E

    • Similar illness and epidemiology to Hepatitis A:
      • Mainly in developing countries, water-borne outbreaks.
      • Commonest cause of ALF in South Asia (genotype 1).
      • Sporadic cases in non-endemic countries (zoonotic, genotype 3).
    • Serological and molecular tests available.
    • Mostly subclinical or mild: Rarely causes acute liver failure.
    • Higher risk of severe disease in pregnant women.
    • No chronic state or carrier state.
      • Chronic disease described in immunosuppressed individuals.
    • Histology: Resembles Hepatitis A.

    Hepatitis B

    • Worldwide burden: 300 million people with chronic HBV disease.
    • Leading cause of: Chronic hepatitis, cirrhosis, and liver cancer worldwide.
    • High-prevalence areas:

      • 8% Southeast Asia, China, Africa

      • 2-8% South Asia, Middle East
      • <2% Western countries.
    • Transmission:
      • Blood-borne, mainly through parenteral routes (e.g., needlestick injuries, blood transfusions).
      • Sharing personal items (razors, toothbrushes).
      • Vertical transmission (mother to child)
    • Risk Factors:
      • IDUs (injecting drug users)
      • Frequent sexual partners/MSM (men who have sex with men)
      • Contacts of infected individuals
      • Children of parents from high-prevalence areas.
    • Clinical Features:
      • Acute infection: Often silent, rarely recognized.
      • Chronic infection: Can lead to cirrhosis and liver cancer.
      • **Pregnant women: **Infants need HBV vaccination and HBIG (Hepatitis B Immunoglobulin)
    • Pathogenesis:
      • HBV integrates into the host's DNA, leading to chronic infection and liver inflammation.
    • Serology:
      • Anti-HBs antibody: Indicates immunity to HBV.
      • HBsAg: Present during both acute and chronic infection
      • **HBeAg: ** Present in patients with high viral loads, indicating active viral replication and a higher risk of infection.

    Hepatitis D

    • Delta agent, a "passenger" RNA Virus:
      • Requires the presence of HBV for replication.
    • Transmission: Blood-borne via the same routes as HBV.
    • Co-infection: Simultaneous HBV and HDV infection.
    • Superinfection: HDV infection in individuals with pre-existing HBV.
    • Increases risk of chronic disease associated with HBV.
    • Typically seen in intravenous drug users.
    • Rare in Ireland.

    Hepatitis C

    • Major cause of: Chronic hepatitis, cirrhosis, and liver cancer worldwide.
    • Worldwide burden: Estimated 180 million people chronically infected.
    • Prevalence: Varies widely depending on geographic location and risk factors.
    • Transmission:
      • Blood-borne, commonly through IDUs.
      • Can occur from contaminated medical equipment, sharing of personal items, or accidental needle sticks.
    • Genotypes: Six genotypes of HCV, influencing disease progression and response to treatment.
    • Clinical Features:
      • Acute infection: Mostly silent and seldom recognized.
      • Chronic infection: Develops in >80% of cases, often identified incidentally.
      • Vague symptoms: Fatigue, arthralgia (joint pain).
    • Pathogenesis:
      • Not fully understood, likely involves prolonged inflammation and immune system dysfunction.
    • Diagnosis:
      • Serology: Anti-HCV antibody indicates exposure, but does not confirm active infection.
      • HCV RNA in blood: Confirms ongoing infection.
      • Genotyping to identify specific genotypes. - Histology
      • Mild chronic hepatitis: Portal tract lymphoid aggregates and follicles, bile duct infiltration by lymphocytes, fatty change, portal and lobular granulomas, giant cell formation.
    • Extra-Hepatic Manifestations:
      • Arteritis
      • Cryoglobulinaemia plus glomerulonephritis
      • Porphyria cutanea tarda (PCT)
      • Higher incidence of diabetes
      • Association with lichen planus, Sicca syndrome and non-Hodgkin lymphoma.
    • Treatment:
      • Direct-acting antiviral agents (DAAs): Highly-effective treatments for HCV infection that target specific viral proteins, leading to sustained virologic response (SVR) in most cases.
    • Sustained virologic response: Leads to reduced risk of progressing to cirrhosis, liver cancer, and better long-term outcomes.

    International Prevalence of Hepatitis Types

    • HAV:
      • Worldwide distribution, but prevalence higher in areas with poor sanitation and hygiene.
    • HEV:
      • Commonest cause of ALF in South Asia (genotype 1).
      • Sporadic cases in non-endemic countries (zoonotic, genotype 3).
    • HBV:
      • Highest prevalence in Southeast Asia, China, and Africa (>8% of the population).
      • Intermediate prevalence in South Asia and the Middle East (2-8%).
      • Lower prevalence in Western countries.
    • HCV:
      • Globally: Estimated 180 million people chronically infected with HCV.
      • Prevalence: Varies significantly based on geographic location and risk group.

    Hepatitis Overview

    • An abnormality present for longer than 6 months is considered chronic hepatitis
    • Some diseases only cause acute hepatitis, such as Hepatitis A and Hepatitis E
    • Other diseases, such as autoimmune hepatitis and Wilson's disease, only cause chronic hepatitis
    • Some causes of acute hepatitis may become chronic, including Hepatitis B and C
    • Acute hepatitis is characterized by diffuse liver damage and inflammation.
    • Prototypical inflammatory cell in hepatitis is the lymphocyte, regardless of the duration of the disease
    • Severe acute hepatitis can lead to acute liver failure
    • Chronic hepatitis is characterized by ongoing effects resembling acute hepatitis, including evidence of hepatocellular damage
    • Chronic hepatitis can be diagnosed through routine testing, investigation of symptoms, follow-up of acute hepatitis, or the presence of cirrhosis and decompensation.
    • Chronic hepatitis shares common risk factors with other chronic liver diseases for fibrosis, progression to cirrhosis, and risk of hepatocellular carcinoma (HCC).

    Causes of Hepatitis

    • Causes of Acute Hepatitis:
      • Viruses (HAV, HBV, HCV, HEV, EBV, CMV, Rubella)
      • Drugs
      • Alcohol (Rare, but can cause acute liver failure in adults)
    • Causes of Chronic Hepatitis:
      • Chronic viral hepatitis (B, C, B+D)
      • Chronic drug hepatitis (rare)
      • Autoimmune hepatitis (always chronic)
      • Wilson's disease (very rare, always chronic)
      • Alpha-1-antitrypsin deficiency (very rare)
    • Chronic Liver Diseases Not Categorized as Chronic Hepatitis:
      • Alcohol-related liver disease
      • Non-alcoholic fatty liver disease (NAFLD)
      • Chronic inflammatory biliary tract diseases (PBC, PSC)
      • Hereditary hemochromatosis

    Assessing Chronic Hepatitis

    • Blood tests (ALT/AST)
    • Viral load (HBV, HCV) or genotype (HCV)
    • Liver biopsy to determine:
      • Grade of necroinflammatory activity
      • Stage of fibrosis (from normal to cirrhosis)
    • Non-invasive assessments of fibrosis (FibroScan)
    • Effectiveness and tolerability of treatment
    • Aim: eliminate, reduce, or delay progression to cirrhosis and reduce the risk of HCC

    Viral Hepatitis

    • Hepatotropic Viruses:
      • Hepatitis A and E (infective hepatitis)
        • Faecal-oral transmission
        • No chronic state for HAV, very rare for HEV
      • Hepatitis B and C (serum hepatitis)
        • Parenteral transmission
        • Risk of chronic state
      • Yellow fever virus
        • Monkey-mosquito-man transmission
    • Other Viral Causes of Acute Hepatitis: EBV, CMV, Rubella
    • Coinfection/Superinfection is Possible: HCV and/or HBV and/or HIV, HBV+HDV

    Hepatitis A

    • Transmission:
      • Faecal-oral spread
      • Personal/sexual contact, epidemics (institutions)
      • Contaminated water/shellfish
    • Clinical Course:
      • Usually subclinical or mild illness
      • More often symptomatic in adults
      • Silent infection in childhood
      • Very rare cause of ALF, jaundice can be prolonged
      • No chronic disease/carrier state
    • Histology:
      • Appearance of acute hepatitis in general
      • Periportal inflammation with plasma cells
      • Cholestasis
      • Acidophil bodies, apoptosis, “Councilman body”
    • Serology: Anti-HAV antibody indicates lifelong immunity
      • IgM anti-HAV indicates acute infection
    • Immunization: Active immunization, especially for those at-risk

    Hepatitis E

    • Clinical Course:
      • Similar illness/epidemiology to Hepatitis A
      • Mostly subclinical/mild, rarely acute liver failure
      • Commonest cause of ALF in South Asia (genotype 1)
      • Sporadic cases in non-endemic countries (zoonotic, genotype 3)
      • Higher risk in pregnant women of more serious disease
      • In general, no chronic disease/carrier state
      • Chronic disease described a/w immunosuppression
    • Histology: Resembles Hepatitis A
    • Serological & Molecular Tests: Now available

    Hepatitis B

    • Prevalence: 300 million worldwide have chronic HBV disease
    • Leading Cause: Chronic hepatitis, cirrhosis, liver cancer
    • Deaths: Up to 1 million deaths annually
    • Transmission: Parenteral
    • Risk Factors:
      • High prevalence in SE Asia, China, Africa
      • Intermediate prevalence in S Asia, Middle East
      • Low prevalence in other parts of the world
      • Children (20-30% get chronic HBV)
      • Adults (2% prevalence)
      • Pregnant women
      • Patients on immunosuppression
      • High-risk groups (IDUs, frequent sex partners/MSM, contacts, children of parents from >8% areas)

    Hepatitis D

    • Delta Agent: RNA virus that requires HBV for replication
    • Transmission: Co-infection with HBV or superinfection on existing chronic HBV
    • Clinical Course: Increases the risk of chronic disease associated with HBV
    • Prevalence: Typically in IDUs, rare in Ireland

    Hepatitis C

    • Major Cause: Major cause of blood or blood-product associated hepatitis (“non-A, non-B hepatitis”)
      • Major burden of chronic infection worldwide (?180m)
      • 6 genotypes
    • Transmission: Blood, IDUs, sporadic
    • Clinical Course: - Acute infection typically silent - Most cases (>80%) progress to chronic infection - Chronic infection often identified incidentally - Chronic HCV vague symptoms (fatigue, arthralgia) - Small % develop extra-hepatic manifestations

    Hepatitis C Diagnosis

    • Serology: Anti-HCV antibody indicates exposure
      • Most with anti-HCV will have active chronic infection
      • Anti-HCV not protective
    • HCV RNA in blood: Confirms ongoing infection
      • Amount of viral RNA is used for treatment decisions
    • Genotype:
      • Type 1a commonest in US, least responsive to interferon
      • Type 1b commonest in Europe
      • Types 2, 3 elsewhere
      • Polymorphism in IFNL3/IL28B gene predicts response in type 1
    • Treatment Response: Nil/minimal RNA after 12 or 24/52 weeks = SVR
      • Sustained virological response (SVR) reduces progression, risk of cirrhosis, HCC

    Hepatitis C Histology

    • Mild chronic hepatitis
    • Portal tract lymphoid aggregates and follicles
    • Bile duct infiltration by lymphocytes
    • Fatty change
    • Sometimes portal and lobular granulomas
    • Giant cell formation

    Hepatitis C Extra Hepatic Manifestations

    • Arteritis
    • Cryoglobulinaemia plus glomerulonephritis
    • Porphyria cutanea tarda (PCT)
    • Higher incidence of diabetes
    • Association with lichen planus, Sicca syndrome and non Hodgkin lymphoma

    Clinical Course of Hepatitis C

    • Chronic HCV:
      • Risk of progression varies (men, age>50, +HIV or HBV alcohol obese worse)
      • May take 20-30 years
      • 20% cirrhosis over 20 years is typical estimate
    • Histology: Indication of damage, requires biopsy
      • Predicts risk of progression
      • Up to recently: guidance to treatment (esp.genotype 1) for interferon-based regimens
      • Now: non-invasive assessments of fibrosis (FibroScan)
    • Biochemistry: May be normal, clinically may be silent

    Clinical Course of Un-Treated HCV

    • Progresses through different stages
    • May ultimately lead to cirrhosis and HCC

    Piecemeal Necrosis/Interface Inflammation

    • Shows inflammation blurring the sharp boundary between the portal tract and the liver parenchyma, with associated damage to liver cells
    • This is a prototypical pattern of chronic hepatitis, especially HBV and autoimmune hepatitis
    • Note that inflammation is often concentrated within the portal tract (center and bottom right)

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Pathological Evaluation of Hepatitis 2024 PDF

    Description

    Test your knowledge on hepatitis, including its acute and chronic forms. Learn about the hepatotropic viruses, their causes, signs, and methods of assessment. This quiz covers essential facts regarding liver function abnormalities.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser