NSG 533 Exam 2: Questions & Answers
when can an individual receive Serum HAV Ig for pre/post exposure prophylaxis?
(Ans- pre:
- <2 weeks before a trip
- under 2 years old
post:
- up to 2 weeks post-exposure
transmission of HBV (Ans- mucosal contact with infected blood or body fluid (saliva, semen)
pathophysiology of HBV (Ans- exposure to HBV --> cell-medicated immune response in cell nucleus --> Cytotoxic T cells and NKC are sent to the virus to release inflammatory cytokines --> initiation of inflammatory response --> HBV infiltrates hepatocytes and replicates quickly
incubation period for HBV (Ans- 60-150 days (average 90)
s/s acute HBV (Ans- general illness (loss of appetite, fever, n/v)
s/s chronic HBV (Ans- JAPSH
- jaundice
- ascites
- peripheral edema
- spider telangiectasias 1 / 3
- hepatosplenomegaly
- positive serum test for 6 months
risk factors for HBV (Ans-
- close contact
- hemodialysis
- IVDU
- tattoos (dye)
abnormal liver enzymes and serological markers for HBV (5) (Ans-
- HBsAg (marker of active disease)
- IgM anti-HBc (recent infection <6months)
- HBcAb Total (golden ticket for immunity)
- HBsAb (surface antibody determines immunity from vaccination)
- HBV DNA PCR Quantitative (viral load - how much viral is in the blood)
treatment of HBV (Ans-
- medication (Tenofovir, Entacivir)
- PegIFN
- oral meds (only effective in chronic disease, stops viral repetition)
when to treat HBV (Ans-
- viremia >2000
- fam hx of HCC 2 / 3
- >40 years old
- ALT elevated more than 2x the upper limit
- liver biopsy
prevention of HBV (Ans- vaccine, especially in hemodialysis patients
transmission of HCV (Ans- infected blood
what are 80% of the new cases of HCV due to?(Ans- PWID (people who inject drugs)
pathophysiology of HCV (Ans- classified into 7 genotypes and several subtypes (1a and 1b cause 60% of cases)
can be acute or chronic
incubation period of HCV (Ans- 2-22 weeks
s/s of HCV (Ans- mostly asymptomatic until irreversible liver damage occurs
abnormal liver enzymes and serologic markers (5) (Ans-
- HCV Ab (only determines if you have been exposed)
- HCV Ab w/ reflex PCR (best lab to order)
- HCV RNA PCR Quantitative (tests for viral load)
- HCV Genotype (used to characterize virus after diagnosis)
- / 3