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FIRST PUBLISH OCTOBER 2024
AHN 574 GI Exam Study Guide with
Complete Solutions
Hepatitis A Symptoms - Ans:✔✔-fatigue, malaise, HA, RUQ pain, nausea, diarrhea, decreased appetite,
weight loss, jaundice, dark urine, clay colored stools
Hepatitis A Transmission - Ans:✔✔-Fecal-oral: undercooked fish, unpeeled fruit or veggies, tap water
while traveling, eating food prepped by infected person
Hepatitis B Symptoms - Ans:✔✔-anorexia, fatigue, malaise, N/V, jaundice, low grade fever, tender
hepatomegaly
Hepatitis B Transmission - Ans:✔✔-Blood-borne, body fluids: body piercing or tattoos, needle sticks,
transfusions, hemodialysis, orally or sexually, mother to child, cocaine use.
Hepatitis C Symptoms - Ans:✔✔-similar to HAV and HBV. Symptoms will be mild with acute HCV, usually
asymptomatic, and characterized by waxing and waning aminotransferase elevations and a high rate
(greater than 80%) of chronic hepatitis. Fatigue is chronic
Hepatitis C Transmission - Ans:✔✔-lood-borne- predominantly parenteral, small risk of sexual/perinatal
transmission
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Hepatitis D - Ans:✔✔-only in association with HBV infection and specifically only in the presence of
HBsAg; it is cleared when the latter is cleared. May coinfect with HBV or superinfect with chronic H
Hepatitis D Symptoms - Ans:✔✔-anorexia, fatigue, malaise, N/V, jaundice, low grade fever, tender
hepatomegaly
Hepatitis D Transmission - Ans:✔✔-blood-borne, body fluids
Hepatitis E geography - Ans:✔✔-primarily in Middle East, Central Asia, and Northern Africa, but should
be considered in patients with acute hepatitis who traveled to those areas.
Hepatitis E Symptoms - Ans:✔✔-anorexia, fatigue, malaise, N/V, jaundice, low grade fever, tender
hepatomegaly
Hepatitis E Transmission - Ans:✔✔-Fecal-oral, waterborne: may be spread by swine, having a pet in the
home and consuming undercooked organ meats or infected cow's milk.
Tests to confirm Hepatitis A - Ans:✔✔-IgM anti-HAV
IgG anti-HAV
CBC
Liver Enzymes
Urine
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IgM anti-HAV - Ans:✔✔--first lab ordered with acute illness with increased ALT and AST activities and
recent icteric illness (<6 months)
-Appears early and disappears in 3-6 months
-Positive- HAV infection within preceding 6 months
-Negative- no HAV infection within preceding 12 months
-IgM- always ACUTE
-Think "M" = Most sensitive
IgG anti-HAV - Ans:✔✔-Rises after 1 month and stays elevated for years (if found without IgM)
-Positive- reflects the presence of IgG antibody when IgM is negative.
-Presence of IgG indicative of previous exposure and non-infectivity (you are not infectious).
-Negative- no previous HAV infection
-IgG- "G" means GONE when found alone
Expected values of CBC in Hepatitis - Ans:✔✔-Normal to Low WBC
Expected values of Liver Enzymes in Hepatitis A - Ans:✔✔-markedly elevated AST/ALT (early), then
↑↑bilirubin, Alk Phos
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Expected values of Urine in Hepatitis A - Ans:✔✔-mild proteinuria, Bilirubinuria may precede jaundice
Tests to confirm Hepatitis B - Ans:✔✔-HBsAg
Anti-HBs
IgM Anti-HBc (Core Antigen)
HBe-Ag
CBC
Liver Enzymes
HBsAg - Ans:✔✔-- Detectable in serum of patients with active viral replication (acute HBV infection)
Anti-HBs - Ans:✔✔--Specific antibody to HBsAg (anti-HBs: antibody to surface antigen)
-appears in most individuals after clearance of HBsAg and after successful vaccination against hepatitis B.
-Disappearance of HBsAg and the appearance of anti-HBs signal recovery from HBV infection, non-
infectivity, and immunity. Would show if had HBV in past, recovered, or immunized.
-If antibody not yet detectable, could miss they had Hep B. To be sure, would test for Anti-IgM-HBc
IgM Anti-HBc (Core Antigen) - Ans:✔✔--present in ACUTE infection; appears shortly after HBsAg is
detected
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