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65 Cards in this Set
- Front
- Back
what is the method of transmission for Hep A? is viremia a component of this virus' infection?
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fecal oral; yes
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to which class of viruses does Hep A belong?
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picornavirus
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where in the world is Hep A most common?
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first world (due to passive-active immunity in 3rd world countries)
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what is the incubation period of Hep A?
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30 days
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what are the symptoms of a patient presenting with Hep A? are LFT's normal or abnormal?
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anorexia, sweating, nausea, jaundice; abnormal
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what is the reason for the jaundice seen in hepatitis patients?
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blockage at secretion of bilirubin into bile
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what is the mechanism of liver destruction in Hep A?
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lysis of infected cells to release progeny virions
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what are the 5 types of epidemics with Hep A?
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1) water borne, 2) raw or undercooked shellfish, 3) within the family, 4) from an infected food handler, 5) from imported fecally contaminated food
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what is notable about the feces in hepatitis patients? The urine?
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it is pale due to lack of bilirubin release into intestine; it is very dark in color
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when do abnormal LFTs show up for a patient with Hep A? with Hep B?
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1.5 months; 4 months
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can Hep A be spread by blood?
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yes
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other than a killed vaccine, how is Hep A treated?
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pooled IgG
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what is the duration of the protection from Hep A provided by pooled IgG?
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4 mos
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what is the mechanism of action of the pooled igG given for Hep A?
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passive active
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what type of vaccine is available for Hep A?
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formaldehyde killed
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does a reliable serological test for Ab to Hep A exist?
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yes
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what does it mean if patient has IgG-/IgM- to Hep A? IgG+/IgM-? IgG+/IgM+?
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current disease is not HepA, never had vaccine or disease; current disease is not Hep A, infected or vaccine in past; acute infection with Hep A or recent vaccine
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why is a IgM+/IgG- rarely seen in a patient tested for Hep A?
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bc the IgG response begins before the patient is symptomatic
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what three parameters are usually used to orient an epidemic?
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place, person, time
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what is the difference between incidence and prevalence?
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incidence has time as a denominator; prevalence has place
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what type of virus is Hep B?
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hepadnavirus
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what is the nature of the DNA of Hep B viruses?
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circular that is mostly ds with some ss regions
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what type of DNA pol is present in the Hep B virion?
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reverse transcriptase
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is the Hep B virus enveloped or not?
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yes
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what is the incubation period of Hep B?
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70 days
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is the onset of Hep A sudden or insidious? Hep B?
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sudden; insidious
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what are the 3 modes of transmission of Hep B?
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bloodborne, STD, perinatal
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is there a serological test available for Hep B?
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yes
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what are the 2 categories of Hep B antigens that have been identified?
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surface (envelope glycoprotein) and core (nucleocapsid)
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which Hep B antigen has the highest correlation to presence of infectious Hep B with progression to hepatic carcinoma?
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E antigen
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what is the mechanism of hepatocyte damage in Hep B?
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Tc cell destruction -- envelopes do not kill cells
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what percentage of Hep B infections are chronic in nature? With which conditions is this chronicity of infection associated?
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5%; chronic hepatits and primary liver carcinoma
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perinatal transmission of Hep B virus from seropositive mothers to neonate will result in what percentage of neonates becoming chronic Hep B carriers? What percentage of these carriers will die of liver cancer or chronic hepatitis?
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90%; 25%
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how can perinatal transmission of Hep B be most effectlvely prevented?
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dual pooled IgG AND killed vaccine (both together)
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what is a subunit vaccine? These are considered to be a member of which vaccine class?
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when only a viral antigen is isolated and injected; killed vaccines
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what type of people usually contribute to the pooled igG used to treat Hep A and B?
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highly immune people -- the most Ab, the better!
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what type of vaccine is the Hep B vaccine?
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subunit
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what is the 'window period'?
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the interval between the time that a donor can transmit the given virus and the time that that donor's infection can be detected by the test done with donated blood
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is the window period generally longer for a serological or PCR test?
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serological
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what type of virus is hep c?
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flavivirus
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what is the nature of the genome of Hep C?
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plus-stranded RNA
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is Hep C an enveloped virus?
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yes
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what is the most commonly performed and most sensitive test for Hep C detection?
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PCR test
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how long is the incubation pd for Hep C?
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60 days
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what is the only confirmed method of transmission of Hep C?
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blood transfusions
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how is the hepatocyte damage performed by Hep C?
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Tc cell destruction -- envelopes do not kill cells
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do most people eradicate Hep C upon recovery from acute primary infection? What is the percentage of chronicity in Hep C?
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no, it sticks around for 10-20 years; 75%
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among Hep A, B, and C, which two are the most similar?
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B and C
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what are prodromal symptoms?
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nonspecific symptoms that appear before the definitive symptom
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what are prodromal symptoms in Hep B and C?
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arthritis and rash
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which Hep viruses can cause chronic hepatitis?
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B and C
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how can chronic hepatitis be treated? Is this successful?
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alpha interferon; not usually
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what is the genomic nature of the Hep D virus?
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circular minus-stranded RNA genome
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what is the unique restriction of infection for Hep D? why is this?
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needs to infect cells that are already infected with Hep B; because they don't have an envelope
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how is the Hep D virus coated?
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with Hep B envelope
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how is immunity to Hep B and D related?
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immunity to B confers immunity to D
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how is liver damage in Hep D achieved?
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Tc cell destruction -- envelopes do not kill cells
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how many proteins unique to hep D are present on cells infected with the virus? Do infected patients make an immune response to this?
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1; yes
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is the onset of Hep D acute or insidious? Is the infection severe?
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acute; yes, life threatening
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what is the genomic nature of Hep E virus? Is it enveloped?
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plus-stranded RNA virus; no
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what is the method of transmisison for Hep E?
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fecal oral
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in which parts of the world is Hep E most prevalent?
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developing world
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what are the two confirmed methods of transmission for Hep D?
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transfusion and STD
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what is the incubation period for Hep E?
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30 days
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infection with which hepatitis viruses is most prone to hepatocellular carcinoma?
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B and C
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