Medical-Surgical Nursing
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| What are the different types of viral hepatitis? | A, B, C, D, and E
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| What is hepatitis? | Inflammation of the liver
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| Which types of viral hepatitis can cause chronic liver disease? | B, C, and D
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| What defines chronic liver disease from viral hepatitis? | Acute viral replication for more than 6 months
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| What type of virus is hepatitis A (HAV)? | An RNA virus
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| What is the incubation period of HAV? | 15-50 days
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| What is the mode of transmission of HAV? | Fecal-oral
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| How is HAV diagnosed? | By the presence of hepatitis A IgM
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| What is the target cell of viral hepatitis? | Hepatocyte
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| True or False: After resolution of an acute infection of viral hepatitis, hepatocytes can regenerate. | True
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| True or False: Once infected with HAV, a patient can never become reinfected. | True
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| What is the first organelle damaged in an hepatocyte by viral hepatitis? | Endoplasmic reticulum
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| What is often the first sign of hepatic encephalopathy? | Changes in handwriting
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| What serum bilirubin level can indicate severe liver damage? | 20 mg/dL for an extended period of time
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| What type of virus is hepatitis B (HBV)? | A DNA virus
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| What is the mode of transmission for HBV? | Percutaneously or perinatal (most common)
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| True or False: HAV cannot live outside the human body. | False; it can live outside the body, possibly for months
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| True or False: Most young children with HAV usually don't have jaundice. | True
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| Can the HAV vaccine be given in pregnancy? | Yes
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| What is the incubation period of HBV? | 45-180 days
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| How long can HBV live on a dry surface? | 7 days
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| True or False: HBV is much more infectious than HIV. | True, by 50-100x
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| Which age group is most likely to be affected by chronic HBV? | Young children
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| What is tested for to diagnose HBV infection? | HBsAG
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| Can the HBV vaccine be given in pregnancy? | Yes
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| What type of virus is hepatitis C (HCV)? | An RNA virus
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| What is the incubation period of HCV? | 14-180 days
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| Why is the "baby boomer" generation (born 1945-1965) at an increased risk of HCV? |
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| Do the majority of HCV infections become acute or chronic? | Chronic
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| True or False: There is no vaccine for HCV. | True
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| How is HCV diagnosed? | By anti-HCV screening tests 4-10 weeks after infection
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| What is the delta virus? | Hepatitis D (HDV)
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| What is the incubation of HDV? | 2-26 weeks
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| What type of virus is HDV? | Single-stranded RNA
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| What does HDV require to replicate? | Coinfection with HBV
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| What is the mode of transmission of HDV? | Percutaneously
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| What type of virus is hepatitis E (HEV)? | An RNA virus
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| What is the incubation period of HEV? | 15-64 days
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| What is the mode of transmission of HEV? | Fecal-oral route, primarily by contaminated water
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| Is there a way to test for HEV? | Not in the United States
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| Which sex is more at risk for chronic HBV? | Men
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| What are clinical manifestations of acute liver failure? | Encephalopathy, GI bleeding, DIC, fever with leukocytosis, oliguria, ascites, edema, hypotension, hypoglycemia, thrombocytopenia, azotemia, and respiratory failure
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| What is azotemia? | A higher-than-normal level or urea or other nitrogen-containing compounds.
Tests: BUN (8-20 mg/dL) and Creatinine (0.7-0.14 mg/dL)
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| What is the only cure for acute liver failure? | Liver transplantation
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| How many genotypes does HCV have? | 6
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| Which genotype of HCV causes most infections? | Genotype 1
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| Why is viral genotyping done with HCV and HBV infections? | The genotype determines the choice and duration of therapy
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| What drug class is used to treat acute HCV? | Direct-acting antivirals (DAAs)
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| In patients with a bleeding disorder, how can a liver biopsy be obtained? | By transjugular liver biopsy
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| What treatment is best for acute HAV and HBV? | Supportive
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| How do nucleoside and nucleotide analogs act? | They inhibit viral replication
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| Which drugs are nucleoside and nucleotide analogs? | Lamivudine (Epivir), adefovir (Hepsera), entecavir (Baraclude), telbivudine (Tyzeka), and tenofovir (Viread)
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| How is PEGylated interferon (PegIntron, Pegasys) administered? | By subQ injection
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| What should be monitored in pts. undergoing interferon therapy? | CBC and LFTs every 4-6 weeks
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| Which nucleotide analog causes severe birth defects? | Ribavirin (Rebetol)
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| What is the normal range for ALT? | 5-30 units/liter (U/L)
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| What is the normal range for ALP? | 50-100 U/L
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| What is the normal range for AST? | 10-40 U/L
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