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Questions and Answers
What does a positive ALT and positive HCV antibody at baseline indicate?
What does a positive ALT and positive HCV antibody at baseline indicate?
At 1-3 months after exposure, if both ALT and HCV antibody test positive, what does this suggest?
At 1-3 months after exposure, if both ALT and HCV antibody test positive, what does this suggest?
Which method can be used to diagnose acute HCV infection within 4 weeks after exposure?
Which method can be used to diagnose acute HCV infection within 4 weeks after exposure?
Which option is NOT a symptomatic treatment for acute viral hepatitis?
Which option is NOT a symptomatic treatment for acute viral hepatitis?
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In which condition is lichen planus likely to be associated with hepatitis C?
In which condition is lichen planus likely to be associated with hepatitis C?
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Which virus is known to not cause chronic hepatitis?
Which virus is known to not cause chronic hepatitis?
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What should be done after accidental exposure to blood from an HBV positive patient if not vaccinated?
What should be done after accidental exposure to blood from an HBV positive patient if not vaccinated?
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Which oral manifestation is associated with hepatitis C infection?
Which oral manifestation is associated with hepatitis C infection?
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What is a common symptom of the icteric phase of hepatitis A?
What is a common symptom of the icteric phase of hepatitis A?
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Which lab findings are expected in someone with acute hepatitis A?
Which lab findings are expected in someone with acute hepatitis A?
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What is the primary mode of transmission for hepatitis A?
What is the primary mode of transmission for hepatitis A?
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What preventative measure is recommended after exposure to hepatitis A?
What preventative measure is recommended after exposure to hepatitis A?
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What is the typical duration for complete recovery from hepatitis A?
What is the typical duration for complete recovery from hepatitis A?
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How can hepatitis A be inactivated on surfaces?
How can hepatitis A be inactivated on surfaces?
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What is a key characteristic of hepatitis A regarding chronic infection?
What is a key characteristic of hepatitis A regarding chronic infection?
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During what period does peak excretion of the hepatitis A virus occur?
During what period does peak excretion of the hepatitis A virus occur?
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What is the primary mode of transmission for HBV?
What is the primary mode of transmission for HBV?
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What characterizes acute hepatitis?
What characterizes acute hepatitis?
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Which of the following types of hepatitis is known to be transmitted through fecal-oral route?
Which of the following types of hepatitis is known to be transmitted through fecal-oral route?
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Which factor increases the likelihood of a mother transmitting HBV to her child during childbirth?
Which factor increases the likelihood of a mother transmitting HBV to her child during childbirth?
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What percentage of adults is likely to develop clinical illness from HBV?
What percentage of adults is likely to develop clinical illness from HBV?
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Which of the following statements about chronic hepatitis is true?
Which of the following statements about chronic hepatitis is true?
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Which virus causes hepatitis that can be transmitted via blood and has a vaccine available?
Which virus causes hepatitis that can be transmitted via blood and has a vaccine available?
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Which of the following is a chronic infection outcome associated with HCV?
Which of the following is a chronic infection outcome associated with HCV?
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Which of the following is NOT a recognized risk factor for HCV transmission?
Which of the following is NOT a recognized risk factor for HCV transmission?
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In which phase of acute viral hepatitis might you first experience flu-like symptoms such as fever and fatigue?
In which phase of acute viral hepatitis might you first experience flu-like symptoms such as fever and fatigue?
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What is the primary marker used for diagnosing HBV infection?
What is the primary marker used for diagnosing HBV infection?
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Which virus is associated with chronic infection but does not have a vaccination available?
Which virus is associated with chronic infection but does not have a vaccination available?
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What is one of the liver's primary functions?
What is one of the liver's primary functions?
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What percentage of people with HCV are likely to develop chronic infection?
What percentage of people with HCV are likely to develop chronic infection?
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Which of the following hepatitis viruses is NOT hepatotropic?
Which of the following hepatitis viruses is NOT hepatotropic?
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Which option describes the nature of HBV as a virus?
Which option describes the nature of HBV as a virus?
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What does HBsAb indicate in a patient?
What does HBsAb indicate in a patient?
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When does HBsAg typically become detectable after exposure to HBV?
When does HBsAg typically become detectable after exposure to HBV?
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Which group is NOT advised to receive the Hepatitis B vaccine?
Which group is NOT advised to receive the Hepatitis B vaccine?
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What is the primary use of HCV-RNA testing?
What is the primary use of HCV-RNA testing?
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What is the recommended action after accidental exposure to HCV?
What is the recommended action after accidental exposure to HCV?
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Which of the following correctly describes the role of HBeAg?
Which of the following correctly describes the role of HBeAg?
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Which of the following statements about the Hepatitis C vaccine is true?
Which of the following statements about the Hepatitis C vaccine is true?
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What is the function of Hepatitis B Immunoglobulin?
What is the function of Hepatitis B Immunoglobulin?
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Study Notes
Viral Hepatitis Overview
- Viral hepatitis is an inflammation of the liver
- Types include acute and chronic hepatitis
- Acute hepatitis is short-term, with the body's immune system clearing the virus within 6 months
- Chronic hepatitis is long-term, lasting more than 6 months due to the body's immune system failing to clear the virus. The duration of the infection is the defining characteristic, not the illness severity.
- Potential outcomes from acute hepatitis include recovery, chronic inflammation, cirrhosis, or HCC (hepatocellular carcinoma)
Liver Functions
- Stores sugar for energy
- Breaks down toxins and drugs
- Creates proteins to build and repair tissue
- Produces bile to aid fat digestion
- Synthesizes blood clotting factors (V, VII, IX, X, prothrombin, fibrinogen)
Causes of Acute Hepatitis
- Viral (hepatotropic): Viruses A, B, C, D, E, G, and non-hepatotropic viruses (CMV, EBV, herpes, HIV)
- Drug-induced hepatitis: Paracetamol, alcohol, halothane
Hepatitis A (HAV)
- Transmission: Fecal-oral
- Incubation period: 15-50 days
- Peak excretion in stool occurs two weeks before the onset of jaundice (during the prodromal phase)
- Risk factors include close personal contact (e.g., households, daycares), contaminated water or food, and travel to endemic regions
- HAV survives hours on fingertips/hands and up to two months on dry surfaces
- Inactivated by heating to 185°F (85°C) or higher for one minute, or by disinfection with a 1:100 dilution of sodium hypochlorite
- Diagnosed by detecting HAV IgM
- No known chronic carrier state; does not cause chronic hepatitis or cirrhosis
- Prophylaxis: Improve hygiene, passive immunity, and vaccination
Hepatitis B (HBV)
- Transmission: Blood and bodily fluids (semen, vaginal fluids)
- Risk factors: Blood transfusion (before 1992), hemophilia, intravenous drug use, multiple sexual partners, hemodialysis, infected mothers transmitting to newborns (high HBeAg levels)
- Diagnosed by HBsAg (general marker), HBsAb (recovery/immunity), HBcAb (IgM or IgG- acute or chronic), HBeAg (active replication), and HBV-DNA (monitoring response to therapy)
- HBsAg is detectable in infected blood on average 4 weeks (1-9 weeks) after infection
- Preventable by passive and active immunity (vaccination)
Hepatitis C (HCV)
- Transmission: Percutaneous exposures to infected blood (e.g., needles, blood transfusions)
- Risk factors include blood transfusions (before 1992), needle sticks, intravenous drug use, hemodialysis, and sexual contact (less efficient transmission)
- Diagnosed using HCV antibody (less useful during acute infection), HCV-RNA PCR (needed for acute diagnosis).
- No vaccine is available.
Hepatitis D (HDV)
- Requires HBV to replicate
- Classified as a coinfection if HBV infection develops simultaneously, or as a superinfection if HDV infection develops after chronic HBV infection.
- Diagnosed by detecting HDV antibodies
Hepatitis E (HEV)
- Transmission: Fecal-oral
- Diagnosed by detecting HEV antibodies
Clinical Stages of Viral Hepatitis (Acute)
- Incubation period (varies by virus)
- Prodromal (preicteric) phase: Flu-like symptoms (fever, sore throat, cough, headache, anorexia, malaise, nausea, vomiting, abdominal pain)
- Icteric phase: Jaundice (yellowing of skin, eyes, and mucous membranes), resolution of fever, and pruritus (itching). Liver enlargement and tenderness, splenomegaly (enlarged spleen) in some cases.
- Convalescence: Resolution of symptoms, complete recovery (duration varies by virus)
Laboratory Diagnoses
- Serum bilirubin: Increased
- ALT/AST (liver enzymes): Marked elevations
- Alkaline phosphatase: Mild elevations
- Prothrombin time (PT): Usually normal, prolonged in severe hepatitis
Oral manifestations of hepatitis C
- Lichen planus
- Sjögrens syndrome
- Xerostomia
- Sialadenitis
- some forms of oral cancers
Treatment of Acute Viral Hepatitis
- Symptomatic treatment: bed rest, light palatable meals. Hospitalization is rare.
Prevention
- Improve hygiene is critical.
- Passive immunity (immunoglobulin for exposure to HBV) and active immunity (vaccines) are important preventive steps.
Post-exposure Procedures for accidental exposure to blood sources from HBV- or HCV-positive patients
- Carefully wash the wound without rubbing using soap and water.
- If necessary, use a disinfectant with established efficacy against the virus (e.g., iodine solution).
- Collect complete medical and clinical information from the patient to assess possible health risks.
Additional notes:
- Multiple, very similar infections: symptoms/signs can't alone distinguish a specific type of viral hepatitis
- Accurate diagnosis relies on lab results
- Various types of oral manifestations exist due to hepatitis C.
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Description
This quiz covers the key aspects of viral hepatitis, focusing on its types, causes, and impacts on liver function. Learn about the differences between acute and chronic hepatitis, including potential outcomes and liver's role in metabolism and detoxification. Test your understanding of the virulent agents and drug-induced factors associated with hepatitis.