Questions and Answers
What is the estimated percentage of the US population that has serologic evidence of a previous infection with HAV?
How is HBV usually transmitted?
What is the risk of infection to an infant born to an HBV positive mother?
Which of the following bodily fluids has NOT been found to contain HBV?
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What is the most common genotype of HCV in the US?
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What is the current leading mode of transmission of HCV in the US?
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What is the risk of infection with HCV after an accidental needlestick?
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What is the risk of sexual or maternal neonatal transmission of HCV?
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What is the primary characteristic of viral hepatitis?
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Which of the following is NOT a common symptom of viral hepatitis?
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What is the primary difference between acute and chronic viral hepatitis?
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What is the significance of viral hepatitis in terms of liver disease?
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How is viral hepatitis often transmitted?
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What is the consequence of viral hepatitis on the immune system?
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What is the consequence of viral hepatitis on the liver?
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What is the long-term consequence of chronic viral hepatitis?
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What is the primary reason for edema in patients with liver failure?
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What is the consequence of impaired metabolism of estrogen in men with liver failure?
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Which of the following is a unique feature of HBV infection?
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Which vitamin deficiency is associated with osteomalacia in patients with liver failure?
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Which of the following is often seen in peripheral blood smears of patients with VH?
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What is the result of impaired elimination of ammonia in patients with liver failure?
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What is the consequence of reduced production of bile salts in patients with liver failure?
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What is the first antibody to appear in the blood in acute HBV infection?
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What is the result of abnormal processing of lipoproteins in patients with liver failure?
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Which of the following is a contraindication in patients with VH?
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What is the consequence of reduced synthesis of clotting factors in patients with liver failure?
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What is the significance of HBeAg in HBV infection?
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What is the most common complication of acute VH?
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What is the result of impaired metabolism of cortisol and aldosterone in patients with liver failure?
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Which of the following is a goal of antiviral therapy for HCV infection?
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What is the significance of HCV RNA testing in patients with HCV infection?
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What is the primary goal of treatment against HCV infection?
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Which of the following is NOT a goal of treatment against HCV infection?
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What is the approximate cost of treatment with peginterferon and ribavirin per year?
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What is the primary treatment for acute hepatitis D?
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What is the primary treatment for chronic hepatitis D?
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What is the primary treatment for acute hepatitis E?
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What is the treatment option for acute fulminant hepatitis with hepatic failure?
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Which of the following hepatitis types has a more successful liver transplantation outcome?
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Study Notes
Viral Hepatitis
- Viral hepatitis is a group of inflammatory liver conditions caused by at least 6 different viral strains.
- Characterized by:
- Low-grade fever
- Fatigue
- Jaundice
- Hepatomegaly
- Anorexia
- Abdominal discomfort
- Abnormal liver function
- Light-colored stools
- Dark urine
- Each type of viral hepatitis differs in:
- Modes of transmission
- Incubation period
- Clinical manifestations
- Degree and persistence of liver injury
- Ability to evolve into a carrier state
- Acute viral hepatitis can last up to 6 months, while chronic viral hepatitis can last more than 6 months and often becomes a lifelong condition.
Significance of Viral Hepatitis
- Considered a preventable illness
- Can cause:
- Fatigue
- Headache
- Muscle aches
- Nausea
- Vomiting
- Diarrhea
- Liver tissue destruction and liver failure
- Transmission from person to person, including mother to infant
- Weakening of the body's immune system
- Increased risk of liver cancer
- Progression from acute to chronic disease
Types of Viral Hepatitis
- Hepatitis A (HAV)
- Caused by a RNA virus
- Transmitted through contaminated food and water
- Incubation period: 2-6 weeks
- Can cause acute liver failure
- Approximately 30% of the US population has serologic evidence of past infection
- Hepatitis B (HBV)
- Caused by a DNA virus
- Transmitted through blood, sexual contact, and mother-to-infant transmission
- Incubation period: 2-6 months
- Can cause chronic liver disease, cirrhosis, and liver cancer
- 8 different genotypes (A-H) impact disease course and response to therapy
- Hepatitis C (HCV)
- Caused by an RNA virus
- Transmitted through blood, sexual contact, and intranasal drug use
- Incubation period: 2-6 months
- Can cause chronic liver disease, cirrhosis, and liver cancer
- At least 6 major genotypes identified
Liver Failure and Complications
- Liver failure can cause:
- Bleeding
- Low serum albumin and protein concentrations
- Edema
- Glucose intolerance
- Bone disease (osteomalacia)
- Feminization in males
- Reduced protein synthesis
- Decreased serum albumin and blood clotting factors
- Impaired glycogenolysis and gluconeogenesis
- Hypoglycemia
- Abnormal processing of lipoproteins and steroid hormones
- Impaired metabolism of endogenous steroid hormones and byproducts of protein metabolism
- Decreased elimination of drugs and toxins
Diagnosis and Treatment
- Diagnosis through:
- Blood tests (e.g., IgM anti-HBcAg, IgG anti-HBcAg, HBeAg, anti-HBeAg)
- Liver function tests (e.g., AST, ALT, bilirubin, alkaline phosphatase)
- HCV RNA testing (e.g., polymerase chain reaction)
- Treatment goals:
- Decrease viral replication or eradicate the virus
- Prevent progression of the disease
- Decrease the frequency of cirrhosis and liver cancer
- Ameliorate symptoms
- Relieve extrahepatic complications
- Treatment options:
- Interferons (e.g., peginterferon and ribavirin) for HCV
- Lamivudine for HBV (ineffective against HBV/HDV co-infection)
- Liver transplantation for acute fulminant hepatitis with hepatic failure
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Description
This quiz covers the definition and characteristics of viral hepatitis, a group of inflammatory liver conditions caused by different viral strains.