Hepatitis

Question 1

What is hepatitis?

Answer 1

Severe liver inflm

Question 2

3 possible causes of hepatitis:

Answer 2

1. Microbes
2. Hepatotoxic drugs
3. Autoimmunity

Question 3

What specific type of microbe is usually the cause of hepatitis?

Answer 3

Viral

Question 4

What are the most common forms of hepatitis?

Answer 4

A, B, and C

Question 5

Out of A, B, and C, which is the worst form of hepatitis?

Answer 5

C

Question 6

The mnfts of the hepatitis’ are similar, but what aspects are different?

Answer 6

• Virus
• Transmission
• Incubation period
• Severity
• Carrier state

Question 7

Describe hepatitis A

4

Answer 7

• Mild, acute form
• Mode of transmission: oral-fecal
• Lasts ~1 month
• Anti-HAV Abs

Question 8

Describe hepatitis B:

5

Answer 8

• More severe
• ~10-15% chronic
• Mode of transmission: blood, bodily fluids, oral, sexual
• Carrier state
• Anti-HBs, anti-HBc, and anti-HBe Abs

Question 9

Where are anti-HBs, anti-HBc, and anti-HBe Abs found?

Answer 9

HBs - On the surface of the virus
HBc - At the core of the virus
HBe - On the envelope of the virus

Question 10

Describe hepatitis C:

Answer 10

• ~80% chronic
• Can be contracted via blood and blood products, IV
  drugs, and high risk sexual practices
• Carrier state
• Anti-HCV Abs

Question 11

What is a another liver issue which may arise as a complication of hepatitis B?

Answer 11

Cirrhosis

Question 12

What are 2 another liver issues which may arise as complications of hepatitis C?

Answer 12

• Cirrhosis

- Liver CA

Question 13

What are the 2 mechanisms involved in hepatitis that result in cell necrosis?

Answer 13

1. Viral injury -> cell necrosis
2. The immune response causes inflm -> tissue damage
   
   • > cell necrosis

Question 14

What structures in the liver are damaged by hepatitis?

Answer 14

• Hepatocytes
• Vasculature
• Ducts

Question 15

What is the role of the hepatocytes?

Answer 15

They are the functional cells of the liver

Question 16

Approximately how long does it take to heal from hepatitis?

Answer 16

~4 months

Question 17

What are the 3 phases of hepatitis?

Answer 17

1. Prodromal
2. Clinical
3. Recovery

Question 18

What mnfts accompany the prodromal stage of hepatitis?

6

Answer 18

• Lethargy
• Myalgia
• Fever
• Abdm pain
• Anorexia
• Nausea/vomiting

Question 19

Is the nausea/vomiting in hepatitis a systemic or local mnft?

Answer 19

Local

Question 20

What is myalgia?

Answer 20

Pain in a muscle or group of muscles

Question 21

When does the clinical stage begin?

Answer 21

About 5-10 days after the prodromal stage

Question 22

What mnfts accompany the clinical stage of hepatitis?

3

Answer 22

• Earlier mnfts worsen
• Hepatomegaly
• Jaundice
• Pruritus

Question 23

What is the hepatomegaly in hepatitis due to?

Answer 23

Inflm and swelling

Question 24

What is the pruritus in hepatitis due to?

Answer 24

The deposition of bile salts in the skin

Question 25

How long does the recovery stage of hepatitis last?

Answer 25

Acute mnfts should subside in about 3 weeks, full recovery in 16 weeks

Question 26

What is used as Dx tools for hepatitis?

Answer 26

- Serology (looking for mnfts) | - Viral testing

Question 27

Which of the hepatitis' is self limiting?

Answer 27

Hepatitis A

Question 28

Why are pts with hepatitis put on bed rest?

Answer 28

To indirectly rest their liver

Question 29

What is done to directly rest the liver when a pts has hepatitis?

Answer 29

- NO alcohol | - NO hepatotoxic drugs

Question 30

T or F: | You can be vaccinated in order to avoid contracting any forms of hepatitis

Answer 30

F, you *can* be vaccinated from A and , but not from C

Question 31

What Tx for hepatitis C has had a success rate of 95% of pts being cured?

Answer 31

A new direct acting antiviral (DAA)

Question 32

Is autoimmune hepatitis a classic or non-classic form of autoimmunity?

Answer 32

Classic

Question 33

T or F: | Autoimmune hepatitis is a mild, but chronic form of hepatitis

Answer 33

F, it is a severe and chronic form

Question 34

In autoimmune hepatitis, there is a mutation on the HLA gene located on which chromosome?

Answer 34

6

Question 35

What are 2 triggers for autoimmune hepatitis?

Answer 35

1. Environmental triggers | 2. Chemical triggers

Question 36

Describe type 1 of autoimmune hepatitis:

Answer 36

- ~80% in women age 40 and under - 1/3 have pre-existing autoimmune disorders - AutoAbs - Anti-nuclear Abs and anti-smooth muscle Abs

Question 37

What is targeted by an anti-nuclear Ab?

Answer 37

Anything with a nucleus

Question 38

What is targeted by an anti-smooth muscle Ab?

Answer 38

Smooth muscle - eg in the blood vessels and ducts in the liver (pro tip: if you replace "ducts" with "ducks", and imagine a bunch of ducks running around the liver, these disorders are a lot more enjoyable)

Question 39

T or F: | Type 2 of the autoimmune hepatitis is less common than type 1

Answer 39

T

Question 40

What age group is generally affected by autoimmune hepatitis type 2?

Answer 40

2 - 14 year olds

Question 41

What are the Abs in autoimmune hepatitis type 2 targeting?

Answer 41

Cytosol and microsomes

Question 42

What is cytosol?

Answer 42

The aqueous component of the cytoplasm of a cell that the organelles and particles are suspended in

Question 43

What are microsomes?

Answer 43

A fragment of endoplasmic reticulum and attached ribosomes obtained by the centrifugation of homogenized cells.

Question 44

What are the mnfts of autoimmune hepatitis?

Answer 44

- Varying severity | - Asymptomatic to liver failure

Question 45

What is the Tx for autoimmune hepatitis?

Answer 45

- Immunosuppressants | - Transplant ??