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lunalovegood's version from 2016-05-02 20:45

Section 1

Question Answer
InfectiousA
SerumB & D
Enterically transmittedE
Parenterally transmitted C (goes through blood and other non-digestive tracts)
Cannot generate disease without BD
FecesA & E
Blood and blood-derived body fluidsB, C & D (parenteral)
HepadnaviridaeB
Never a chronic diseaseA & E
Often a chronic diseaseB, C, D
Fulminant hepatitis, cholestatic hepatitis, relapsing hepatitisA
Symp at 4-5 weeks, ALT goes up due to liver damage, the more virus the more ALT upA
Children serve as a reservoir of infectionA (increased risk are travelers, homosexual men, injecting drug users)
Can give immunoglobulin pre or 14 days post exposureA
Can give immunoglobulin to protect those who are exposed within 48hrs of incidentB
Chronic persistent hep asymp - Chronic active hep symp - cirrhosis - hepatocellular carcinomaB
0.5-1% acute case fatality rate. <5yo 30-90% are chronic infection. 5 yo 2%-10 are chronic infection. Premature mortality from chronic liver disease 15-25%.B
No vaccine availableC
70% get chronic hep. 85-100% get persistent infectionC
1-3% die. Pregnant women are more vulnerable at 15-25%.Illness severity is increased with age.E
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Chronic Infection
Question Answer
Ano
Byes
Cyes
Dyes
Eno
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Prevention
Question Answer
Apre/post exposure - immunization
Bpre/post exposure - immunization
Cblood donor screening ; risk behavior modification
Dpre/post exposure - immunization ; risk behavior modification
Eensure safe drinking water
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Virion
Question Answer
A27nm icosahedral
B42nm spherical
C60nm spherical
D35nm spherical
E30-32 icosahedral
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Incubation Period
Question Answer
30 days (range 15-50 days)A
60-90 days (range 45-180)B
6-7 weeks (range 2-26 weeks)C
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40 days (range 15-60 days) E

 

Jaundice
Question Answer
<6 is 10% - 6-14 is 40-50% - over 14 is 70-80%A
<5 is <10% - 5 yrs is 2-10%B
30-40%C
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Transmission
Question Answer
Close personal contact, contaminated foodwater, blood exposure (rare)A
South America, Africa, Indo-asia, GreenlandA
Africa, Alaska, Northern Canada, China, BrazilB
Sexual, parenteral, perinatalB
Tranfusion, transplant, injecting drug use, hemodialysis, needles, sexual, close personal contact, perinatal C
Egypt > Brazil Russia Saudi ArabiaC
Percutanous & permucosal exposuresD
China, Indo-asia, Northern Africa, MexicoE
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Lab Diagnosis
Question Answer
Acute HAV-IgM by EIA - Past infection HAV-IgG by EIAA
Hep BsAg is the first antigen detectable in plasma.B
Acute form the HBs goes up then down. Chronic it stays up.B
Takes 4 wks for antibody to appearC
May be used to diagnose HCV infection in the acute phaseHCV-RNA
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Hepatitis B Virus in Various Body Fluids
Question Answer
bloodhigh
serumhigh
wound exudateshigh
semen/vaginal fluidmoderate
salivamoderate
urine, feces, sweat, tears, breastmilklow
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Treatment
Question Answer
Interferon and LamivudineB
For HBeAg positive carriers with chronic active hepatitis. Response rate is 30-40%Interferon
Hep B tx - a nucleoside analogue reverse transciptase inhibitor - tendency to relapse on cessation of Tx - rapid drug resistanceLamivudine
Inferferon and RibavirinC
Hep C Tx - response rate is 50% - 50% of responders will relapse upon withdrawal of TxInterferon
T/F - Hep C Tx - Studies suggest that combination of interferon and ribavirin are more effective than interferon alone.T
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