Hepatitis Flashcards MD2 Block 3 — TBL Prep + CAS Study

These flashcards cover crucial information about hepatitis, its types, associated laboratory findings, transmission, and serology, providing a comprehensive study guide for exam preparation.

What is hepatitis?

Hepatitis is inflammation of the liver parenchyma, caused by viruses, alcohol, drugs, toxins, or the body's immune system.

What two lab enzymes indicate liver inflammation, and why do they rise?

Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) rise when liver cells are damaged and leak these enzymes into the bloodstream.

In most viral or toxic hepatitis, which enzyme is higher: ALT or AST?

In most cases, Alanine aminotransferase (ALT) is higher than Aspartate aminotransferase (AST), except in alcoholic hepatitis.

What causes dark urine in hepatitis?

Dark urine occurs due to the build-up of conjugated (direct) bilirubin in the blood that spills into urine when the liver is inflamed.

What are the two forms of bilirubin and which causes dark urine?

Unconjugated (indirect) bilirubin is fat-soluble and cannot be excreted in urine; conjugated (direct) bilirubin is water-soluble and causes dark urine.

What is ballooning degeneration of hepatocytes?

A microscopic finding where liver cells swell and look bloated under the microscope, indicating cell injury.

What are Councilman bodies?

Small, shrunken, pink-staining dead liver cells that form during apoptosis in liver cells.

What is the unique microscopic finding in Hepatitis B virus infection?

Ground-glass hepatocytes, which appear pale and smooth under the microscope due to accumulation of HBsAg.

What are the unique microscopic findings in Hepatitis C virus infection?

Lymphoid aggregates in portal tracts and macrovesicular steatosis (large fat droplets inside liver cells).

What are Mallory bodies and which disease are they associated with?

Mallory bodies are clumps of damaged intermediate filaments in liver cells, associated with alcoholic hepatitis.

What does lobular disarray mean in hepatitis?

A disorganized appearance of liver cells under the microscope due to inflammation and cell death.

What is the transmission route of Hepatitis A virus and Hepatitis E virus?

Both are transmitted via the fecal-oral route, commonly through contaminated food or water.

Why is Hepatitis E virus especially dangerous in pregnant women?

It has a very high mortality rate in pregnant women, particularly in the third trimester.

What is the transmission route of Hepatitis B virus and Hepatitis C virus?

Both are transmitted parenterally (through blood) and sexually.

What type of genetic material does Hepatitis B virus have?

Hepatitis B virus is a DNA virus, the only hepatitis virus with a DNA genome.

What dangerous complication can Hepatitis B virus cause?

Hepatitis B virus can cause hepatocellular carcinoma (HCC) without first causing cirrhosis.

What is the chronicity rate of Hepatitis C virus?

Approximately 80% of people infected with Hepatitis C virus develop chronic infection.

What is Hepatitis D virus and why cannot it infect on its own?

Hepatitis D virus is a defective RNA virus that requires Hepatitis B virus to infect liver cells.

What is the difference between co-infection and superinfection with Hepatitis D virus?

Co-infection occurs when Hepatitis B and D viruses infect simultaneously, while superinfection occurs when someone with chronic Hepatitis B gets infected with Hepatitis D later.

What does Hepatitis B surface antigen (HBsAg) indicate when positive?

A positive result means the person is currently infected with Hepatitis B virus.

What does Anti-HBs being positive mean?

It indicates immunity to Hepatitis B virus from recovery or vaccination.

What is the window period in Hepatitis B virus infection?

The gap when both HBsAg and Anti-HBs are negative, with only Anti-HBc IgM being positive.

What is Anti-HBc and what is the difference between IgM and IgG?

Anti-HBc indicates infection; IgM means acute infection, while IgG indicates past infection.

What does Hepatitis B e-antigen (HBeAg) indicate?

A positive result indicates high replication of the virus and high infectivity.

How to distinguish acute from chronic Hepatitis B using lab markers?

Acute: HBsAg positive for

What is alcoholic hepatitis and the classic lab pattern?

Liver inflammation due to alcohol use; classic pattern is AST higher than ALT in a 2:1 ratio.

Why does alcohol cause AST to rise more than ALT?

Alcohol damages mitochondria, affecting the release of AST over ALT.

What is autoimmune hepatitis diagnosed with?

Diagnosed by finding Anti-smooth muscle antibodies (ASMA) in the blood.

What is toxic hepatitis and its important example?

Liver inflammation from drugs; acetaminophen (tylenol) overdose is a key example.

What is the treatment for acetaminophen overdose?

N-acetylcysteine (NAC), which replenishes glutathione levels.

What is steatohepatitis and its two types?

Fatty liver plus inflammation; two types are alcoholic and non-alcoholic steatohepatitis.

What are the transmission routes for each hepatitis virus?

A - fecal-oral, B - parenteral/sexual, C - parenteral, D - parenteral with B, E - fecal-oral.

Which hepatitis viruses can cause chronic infection?

B - 5-10%, C - 80%, D - if superinfection; A and E are never chronic.

Which hepatitis viruses are linked to liver cancer?

B and C; B can cause cancer directly without cirrhosis.

What are the 5 key Hepatitis B serology markers?

HBsAg, Anti-HBs, Anti-HBc IgM, Anti-HBc IgG, HBeAg.

What is the diagnosis with HBsAg positive, Anti-HBc IgM positive, HBeAg positive?

Acute Hepatitis B virus infection.

What is the diagnosis with negative HBsAg, negative Anti-HBs, positive Anti-HBc IgM?

The window period of Hepatitis B infection.

What is the diagnosis with negative HBsAg, positive Anti-HBs, positive Anti-HBc IgG?

Resolved past Hepatitis B virus infection with natural immunity.

What is the diagnosis with positive HBsAg, positive Anti-HBc IgG, and positive HBeAg?

Chronic Hepatitis B virus infection with active viral replication.

How do you tell apart a vaccinated person from a recovered person?

Vaccinated have Anti-HBs positive + Anti-HBc negative; recovered have Anti-HBc IgG positive.

What is the diagnosis of a patient with positive HBsAg, positive Anti-HBc IgG, and negative Anti-HBc IgM?

Chronic Hepatitis B virus infection.