DH theory

  1. what is viral hepatitis?
    inflammation of the liver
  2. name all the types of hepatitis
    • hep A
    • hep B (HBV)
    • hep C (HCV)
    • hep D (delta agent)
    • hep E (HEV)
  3. how is hepatitis A transmitted?
    • fecal/oral
    • waterborne/foodborne
    • blood
  4. what is the incubation period for hep A?
    15-45 days
  5. when is the communicable stage of Hep A?
    2-3 week period before the onset of jaundice, then diminishes shortly after jaundice appears
  6. true or false. carrier state is not demonstrated with hep A.
  7. what are the signs and symptoms of hep A?
    • preicteric (before jaundice)
    • icteric (during jaundice)
    • anicteric (no jaundice, but still have it)
  8. icteric phase of hep A
    • abrupt onset of flu like symptoms in adults
    • jaundice is present, but rarely appears in children
  9. preicteric phase of hep A
    • abrupt onset of flu-like symptoms
    • liver is enlarged and tender upon palpation
  10. anicteric phase of hep A
    • absence of jaundice
    • 2-3 times more prevelant than icteric
    • often misdiagnosed because of this
  11. what factors influence immunity to hep A?
    • the anti HAV from having the disease
    • some get it without even knowing they had the disease
    • the vaccine
  12. name 3 effective ways to prevent hep A in every day life
    • personal hygiene
    • making sure your food is cooked all the way
    • being extra sanitary in public health situations
  13. name 3 effective ways of preventing hep A in the dental setting
    • standard precautions
    • sterilization
    • disposable material
  14. name 6 groups of people who are at high risk for hep A
    • travelers
    • homosexual men
    • drug users
    • clotting disorders
    • chronic liver disease
    • children in low income, third world countries
  15. how is hep B different from hep A?
    • mode of transportation
    • incubation period
    • onset
    • exisitence of chronic carrier state
  16. true or false HBV has increased significantly during the past 20 yrs
  17. name 3 modes of transportation for HBV
    • percutaneous (needle stick)
    • blood transfusion
    • sexual exposure
  18. can HBV be transmitted to a fetus from the mother?
    yes, during pregnancy, or at birth
  19. infants with HBV are at high risk for chronic infection. What can this lead to?
    chronic liver disorder, or cancer of the liver later in life
  20. define risk population pertaining to HBV.
    • thise that have an increased pervalence of infection, increased chances, or likelihood of infection
    • increased presence of disease carriers
  21. name 14 groups of people who are at a high risk for HBV
    • infants
    • IV drug users
    • mental institutions
    • hemodialysis
    • recipients of blood products
    • liver disease
    • male prisoners
    • health care personnel
    • contact with HBV carriers
    • military populations
    • morticians and embalmers
    • immigrants and refuges
    • sexual contact
  22. what is the incubation period for hep B (HBV)
    • 2-6 months
    • average of 60-90 days
  23. what presents in the blood to indicate HBV communicability?
    HBsAG which can be found in the blood as early as 30 days after exposure to the disease
  24. when is HBsAG no longer detectible in the blood of pt with HBV?
    after jaundice
  25. what would make the hep B (HBV) a transient infection to a pt?
    the pt would have a rapid, strong, immune response to the hep virus, and the virus would be destroyed before it was even established
  26. describe acute type B in HBV
    • onset is slower than other hep viruses
    • cannot be distinguished on basis of clinical signs and symptoms
    • period of illness is longer than hep A
  27. define a chronic carrier of HBV
    an individual with the HBsAG marker in the blood serum for more than 6 months
  28. what are the percentages of individuals who will develop chronic HBV at childhood age, after age 5, and infants
    • 5-10 % after age 5
    • 30 % between age 1 and 5
    • 90% infants infected at birth
  29. how can you detect HBV immunity?
    • presence of anti-HB's - this presence can be unknown due to people who have strong immune systems
    • or from pretesting
  30. name 3 effective ways to prevent HBV
    • transmission in infancy and childhood
    • enforce blood bank control measures
    • enforce sterilization/disposable syringes and needles
  31. describe the HBV active immunization
    it is plasma derived, and has recombinant RNA
  32. what is the most common chronic blood borne infection in the US? and has the most frequent indication for liver transplants?
    Hepatitis C
  33. what was the original name for Hep C?
    hep non A, non B
  34. how is HCV transmitted?
    • percutaneous
    • saliva
    • nonpercutaneous
  35. describe the onset of hepatitis C
    pt can have no clinical symptoms, or can have abdominal discomfort, nausea, vomiting, and can progress to jaundice
  36. what happens to pt with hep C after acute infection?
    50-80% will become chronically infected (carriers) and more than 70% of those will develop serious liver disease
  37. name 13 risk factors for Hep C
    • severe liver disease may occur for those infected with HCV
    • older than 40 at infection
    • males
    • moderate-heavy alcohol intake
    • coinfection
    • blood transfusion before 1991
    • IV drug use
    • intranasal cocaine user
    • tattooing, ear/body piercing
    • perinatal
    • sexual
    • hemodialysis
    • organ transplantation
  38. is there a vaccine for Hep C?
  39. what is the best way to prevent hep C?
    • strict standard precautions
    • behavior modifications
    • careful of transmission in childhood
    • enforce blood banck control measures
    • enforce sterilization/disposable syringe and needles
  40. What is a coinfection with HBV?
    Hepatitis D
  41. how is Hep D (delta agent) transmitted?
    • multiple exposures to HBV
    • blood and body fluids
    • contaminated needles
    • sexual
    • perinatal
  42. is hep D or B more sever?
    hep D
  43. coinfection for Hep D
    acute delta hepatitis occuring with acute HBV infection may lead to resolution of both types. clearance of HBV may lead to clearance of delta virus
  44. superinfection of hep D
    actue delta hepatitis is superimposed on an existing carrier HBV state. the HBV carrier state remains unchanged, and a delta carrier state may develop in addition
  45. superimposition of hep D
    chronic delta hepatitis superimposes on the chronic HBsAG carrier
  46. How do you prevent Hep D?
    • the same measures used for Hep B
    • hep B immunization may protect against hep D
  47. what is hep E (HEV) similar to?
    hep A's clinical course and distribution
  48. how is hep E transmitted?
    • contaminated water
    • person-to person through oral/fecal route
  49. who are highly affected by hep E?
    • adults more than children
    • pregnant women
  50. what is the best way to prevent hep E?
    • sanitary disposal of waste
    • handwashing
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DH theory