-
True/false: All hepatitis virus causes the same clinical symptoms
True: Fatigue, loss of appetite, jaundice, dark urine, clay-colored stools
-
What are the liver enzymes that gets elevated with acute hepatitis?
- ALT
- AST
- (these are aminotransferases)
-
Fever, malaise, anorexia are symptoms of ______ phase of acute hepatitis
Prodromal
-
Nausea, vomiting, abdominal pain, fever, chills are symptoms of ______ phase of acute hepatitis
Preicteric (first phase)
-
Dark urine, increase in serum levels of liver enzymes are signs and symptoms of _____ phase of acute hepatitis?
Icteric sign
-
True/false: hepatitis is cytotoxic where the virus cause direct lysis of host cells
False; they are all non-cytotoxic, no direct lysis of host cells
-
What causes damage to hepatocytes with hepatitis virus infection?
Cell-mediate immunity causes cell death, not direct lysis of host cells
-
Which type of T cell is released during Hepatitis viral infection, and what is the associated antigen?
- Cytotoxic T cell (CD8)
- Class I MHC
-
Which Hepatitis viruses are transmitted via fecal-oral route?
Hep A and E
-
Which hepatitis viruses are transmitted via parenteral, or sexual routes?
Hep B, C, and D
-
Which Hepatitis viruses are often linked to IV drug use?
Hep B, C, and D
-
Non-Envelope hepatitis virus?
Hep A and E
-
Envelope hepatitis virus?
Hep B, C, D
-
Viruses causing chronic hepatitis?
Hep B, C, D
-
True/false: A and E hepatitis viruses causes only acute hepatitis
True
-
Which hepatitis virus has double stranded DNA genome?
Hep B virus
-
Which hepatitis virus is SS (-) RNA?
Hep D virus
-
______ carries its own DNA polymerase and reverse transcriptase
Hepatitis B virus
-
______ is defective
Hep D, requires co-B infection
-
_______ has a circular partially ds DNA.
Hep B
-
Hep A is ______ family. Hep B is ______ family. Hep C is ______ family. Hep D is _____ family. Hep E is ______ family.
- PicoRNAviridae
- HepaDNAvirdiae
- Flaviviridae
- Deltaviridae
- Hepeviridae
-
Which hepatitis virus are enterovirus?
Hep A and E
-
Which virus is bad for pregnant women?
Hep E – high mortality in third trimester
-
Vaccines are available in which viruses?
-
What does the Baltimore IV classification tell you about the RNA genome?
SS + -- meaning the RNA can get translated straight away so the genome is infectious
-
How many serotype does HAV have?
1 serotype , this is why vaccination works
-
True/false: envelope virus is more virulent than nonenvelope
False; for envelope virus, if the envelope is destroyed then it is game over for those viruses since all their survival shit is within that envelope
-
True/false: Hep A is released from host cell by exocytosis, but this is not the case for all picoRNAviruses
True
-
What is a common source of HAV transmission?
From raw or undercooked shellfish from contaminated waters
-
True/false: HAV is shed in feces 2 weeks before symptoms appear, so quarantine is not warranted
True
-
Ig____ indicates active/ recent infection, Ig_____ indicates life long protection/ old, resolved disease
-
What is the gold standard for detecting HAV infection?
IgM
-
How many genotypes are there in HEV? How are they categorized?
- 4
- HEV 1 + 2-> endemic in developing regions, waterborne epidemics
- HEV 3+4 -> developed regions (swine usually )
-
True/false: HEV only has one serotype
False; HAV only has 1 serotype, HEV has 4 genotypes.
-
HEV 1+3 are found in_______ regions, HEV 3+4 are in ______ regions
- Developing regions
- Developed regions
-
True/false: HEV can be transmitted iatrogenically such as touching a patient without proper hand washing
True
-
True/false: HEV is usually self-limiting
True
-
True/false: HEV can cause chronic hepatitis, cirrhosis, liver failure, and HCC
FALSE; HEV CANNOT cause HCC, but can lead to chronic hepatitis, cirrhosis, liver failure in immunocompromised patients
-
Diagnostic method for HEV?
Test for anti-IgM. In immunocompromised patients; even if IgM negative, still test for presence of HEV RNA
-
True/false: HEV causes >80% of cases of fulminant hepatitis (acute liver failure)
True; again, there is no chronic stage caused by HEV, unless it is immunocompromised patient
-
An important feature of HCV is that their 2 surface glycoproteins have _______ regions
Hypervariable – this his why there is no vaccine for this
-
What is the primary transmission of HCV?
Blood
-
True/false: needle stick injury injury risk is higher with HCV than HBV
False; HBV is more than HCV
-
There ____ (is/is not) oncogene in HCV viral genome. How is cancer caused in HCV positive patients/
- Is not
- Cancer is most likely caused by prolonged damage to liver cells
-
What greatly enhances rate of HCC development in HCV positive patients?
Alcoholism
-
People with cirrhosis has a higher chance of developing what?
HCC (hepatocellular carcinoma)
-
In chronic HCV infection, antibody to HCV is _____. In acute HCV infection, antibody to HCV is _____ early on
- Positive
- Negative early on, positive in 6-24 weeks
-
Describe viral load of HCV RNA in serum in acute vs chronic HCV infections.
- Detectable RNA viral load in acute within 1-2 weeks
- Detectable in chronic
- Undetectable once recovered from HCV infection
-
What is the ALT level in Acute HCV vs Chronic HCV infections?
- Acute – elevated
- Chronic- typically elevated but fluctuates to near normal
-
True/false: when ELISA is positive for anti-HCV antibodies, must do PCR for HCV RNA
True
-
True/false: HCV can be distinguished/diagnosed via IgM detection
False; no IgM or IgG distinguishing results in HCV
-
True/false: Treatment for chronic HCV can reactivate HBV infection
True; no one knows how but it’s just how it is
-
Acute HCV, treat with ____. Chronic HCV, treat with ___
- Peginterferon alpha
- Chronic treat with antivirals that stops RNA replication
-
True/false: Hepatitis B is SS+ RNA
False; Hep B is the only DNA hepatitis virus that is double stranded and circular
-
HBV antigen that is important for lab diagnosis and immunization is _____
HBsAg
-
True/false: there is only one genotype of Hep B
True! (like Hep A, that’s why they have vaccines for them)
-
Hepatitis virus that has DNA polymerase is ____
HBV
-
True/false: HBeAg antigen is found on the envelope
False; HBeAg is found lined inside of the nuclear capsid, E is NOT for envelope
-
HBx protein is associated with development of what?
HCC (hepatocellular carcinoma)
-
Transmission route of HBV?
- Blood
- Sexual intercourse
- Mother to newborn during birth (like HCV)
-
What defines Chronic HBV?
HBsAG present for at least 6 months
-
HBeAG, the E-antigen measures _____
Transmissibility; higher the antigen, more infectious it is
-
True/false: Antibody against HBeAg are protective, like antibody against HBsAg
False; HBeAg not protective because they are inside nuclear capsid
-
What is the window period?
time between disappearance of surface antigens and appearance of surface antibodies
-
HBsAg appears during ____ period and ____ phase and falls to undetectable levels soon after.
- Incubation period
- Acute phase
-
IgM is against which HBV antigen?
HBcAg (core antigen)
-
Which HBV antibody is important for window period diagnosis?
HBcAgb(antibody against core antigen)
-
Which HBV antigens are positive uring acute disease?
-
What tests positive in HBV serology in complete recovery?
- HBsAb (surface antibody, not antigen)
- HBcAb (core antibody, not antigen)
-
What tests positive in HBV serology in chronic carrier state? Immunized state?
- Chronic- positive HBsAg (surface antigen), HBcAb (core antibody)
- Immunized- postivie HBsAb (surface antibody)
-
HBV vaccine targets what?
Surface antigen- HBsAg
-
True/false: there is no antiviral for acute HBV. But there is for chronic HBV
True- goal is to reduce DNA viral load
-
HBeAg indicates ____ probability of transmission. HBeAb indicates _____ probability of transmission
- High (E antigen indicates high transmission)
- Low (E ANTIBODY indicates low transmission)
-
Which is the only SS NEGATIVE RNA Hep virus?
Hep D virus
-
True/false: HDV Steals surface antigen of HBV (HBsAg)
True
-
How is HDV transmitted?
Similar as HBV: sex, blood, perinatally
-
HDV co-infection is_________. HDV Superinfection is ________.
- Coinfection- HBV and HDV acquired AT THE SAME TIME
- Superinfection HBV infection FOLLOWED by HDV infection
-
True/false: HBV + HDV hepatitis is more than HBV hepatitis alone
True
-
HDV Superinfection can lead to what?
Fulminant, life-threatening hepatitis liver failure
-
How is HDV diagnosed?
Presence of Delta antigen or IgM to delta antigen
-
Having IgM for both HBV and HDV indicates ____
Coinfection
-
In chronic HDV infection, HDAg is _____, IgM anti-HBC is ______.
- Negative
- Negative
- (Rest of serology markers positive)
-
In acute HDV superinfection, IgM anti-HBC is _______
- Negative
- (rest of serology markers positive)
-
True/false: In Acute HBV/HDV coinfection, every serology marker is positive
True
-
True/false: Person immunized against HBV can still be infected with HDV
False; immunized against HBV will not be infected with HDVV as there are no HBV surface antigen for HDV to steal!
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