Hepatitis Information and Courses from MediaLab, Inc.
These are the MediaLab courses that cover Hepatitis and links to relevant pages within the course.
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| Clinical Significance Liver damage or an obstructed bile duct allows conjugated bilirubin to enter the circulation and ultimately to appear in the urine. Patients with clinical jaundice due to hepatitis or cirrhosis will have bilirubinuria. If the jaundice is due to red cell destruction, there is an increase in unconjugated bilirubin which the kidneys cannot excrete. | View Page |
| Clinical Significance Urinary urobilinogen may be increased in the presence of a hemolytic process such as hemolytic anemia. It may also be increased with infectious hepatitis, or with cirrhosis. Comparing the urinary bilirubin result with the urobilinogen result may assist in distinguishing between red cell hemolysis, hepatic disease, and biliary obstruction. Urobilinogen is increased in hemolytic disease and urine bilirubin is negative. Urobilinogen is increased in hepatic disease, and urine bilirubin may be positive or negative. Urobilinogen is low with biliary obstruction, and urine bilirubin is positive. Reagent strips methods however, cannot distinguish normal urobilinogen from absent urobilinogen, as might be seen in complete biliary obstruction. | View Page |
| Fresh frozen plasma : | View Page |
| Autologous blood must be tested for which of the following before transfusion: | View Page |
| Increases in blood ammonia levels would be expected in which of the following conditions: | View Page |
| Increases in LD fractions 4 and 5 are indicative of: | View Page |
| Which of the following infectious agents represent the greatest risk to the laboratory worker: | View Page |
| Which one of the following statements about Hepatitis is true? | View Page |
| If greater than 50% lymphocytes were found on the peripheral blood smear of a 5 month old child you would suspect which of the following conditions: | View Page |
| Flow cytometry is not a useful tool in the study of this disorder: | View Page |
| Which one of the following statements about Coxiella burnetii is not true: | View Page |
| Which of the following hepatitis antigens is most directly linked to transmission of HBV: | View Page |
| Match the type of hepatitis with its route of transmission | View Page |
| Match the virus with its disease: | View Page |
| Each of the following is related to the virulence of Listeria monocytogenes except: | View Page |
| Serum Iron Serum iron (SI) is a measure of circulating iron bound to transferrin and is reflective of total body iron. SI is elevated in hereditary hemochromatosis (HH) and acute hepatitis. SI is decreased in iron deficiency anemia and chronic inflammation. SI concentrations exhibit diurnal variation, with the lowest values occurring around midnight. In addition, specimens collected from the same individual at the same time of the day may exhibit day to day variations as high as 40%. SI determinations are also affected by diet, menstrual cycle, pregnancy, ingestion of iron supplements, and oral contraceptive use. SI levels alone are considered insensitive indicators of HH. SI is typically measured on automated analyzers using spectrophotometric methods. Iron in the sample is released from transferrin with an acid reagent, reduced to the ferrous state, and reacted with a chromogen such as bathophenanthroline or ferrozine. The intensity of the color change is proportional to the iron concentration. Interference can arise from the use of a hemolyzed sample and contamination of reagents and water with iron. A typical reference interval for SI is 60 - 150 micrograms/dL. SI is usually ordered along with its companion test, the total iron binding capacity (TIBC), or with transferrin (Tf).(2) | View Page |
| Transferrin Saturation Transferrin saturation (TS) is usually reported along with the SI and TIBC. TS indicates the percent of iron binding sites on transferrin that are carrying iron. TS is derived from a calculation using the formula:TS =(SI/TIBC) x 100TS results are reported as percentages. Typical reference intervals for TS are 20% to 55% for males and 15% to 50% for females. TS is generally considered to be the most sensitive laboratory test for detecting altered iron metabolism in hereditary hemochromatosis (HH). It may be elevated prior to significant deposition of tissue iron. TS levels increase as additional iron is accumulated.A drawback to using the TS is that it is dependent on performing both the SI and TIBC. The UIBC (see section below) may be a lower cost alternative.The optimal TS criterion for detecting HH is controversial. Using a TS of >60% for males and >50% for females has been found highly accurate in detecting abnormal iron metabolism in persons with HH. Others studies suggest using lower TS levels, e.g. 45%, as a criterion indicating further testing is warranted. Current guidelines from the American College of Physicians include a TS cutoff level of >55% for identifying iron overload. (11)Patients with initially increased TS should be followed by performing a second TS from a fasting morning specimen. The patient should also be advised not to take vitamins supplemented with iron or oral contraceptives for several days prior to the repeated test. TS levels may be affected by diurnal variation, dietary factors, and co-existing disease states such as inflammation and hepatitis. Patients with HH may have falsely normal TS if chronic blood loss or inflammatory disease is present. | View Page |
| Increase Marrow Iron Stores Markely increased stainable iron is present in this biopsy. Iron stores may be increased in sideroblastic anemia, chronic infections, hemochromatosis, hemosiderosis due to numerous blood transfusions, chronic hepatitis, cirrhosis, and uremia. | View Page |
| Assayed and Unassayed Controls Commercially prepared controls come in either assayed or unassayed forms. Assayed controls are tested by multiple methods before sale, and are sold with the results of the tests. Assayed controls: are more expensive than unassayed controls are used to evaluate accuracy and precision avoid laboratory errors in determining control values may only be suitable for specific methods or conditionsWhile the manufacturer's control values can be used to some extent to measure accuracy, the best measure of accuracy is certified reference material.Unassayed controls are not tested by the manufacturer before they are sold. The control values for these materials must be determined by the individual laboratory. Unassayed controls: are less expensive than assayed controls are used to evaluate precision only avoid manufacturer error in determining control values control values are customized to the laboratory's own methods and conditionsA final note: although commercially available control materials are screened for hepatitis antigens and HIV antibodies, control materials should still be handled with precautions, since they contain biological materials and could contain infectious agents. | View Page |
| What happens after HBV infection? After the exposure, there is an incubation period that lasts between 45 and 180 days, with an average of 90 days.Many individuals with acute HBV will have no symptoms at all. Some will have a mild illness with loss of appetite, nausea and vomiting, and fatigue. About 30% of infected individuals will develop clinical hepatitis with jaundice (yellow discoloration of the skin and eyes due to liver dysfunction). | View Page |
| What Causes Hepatitis B? Hepatitis B is caused by the Hepatitis B virus, or HBV.Following introduction of the virus into a susceptible person, it travels through the blood stream to the liver. Once in the liver the virus will multiply and cause hepatitis (inflammation of the liver). | View Page |
| Serious adverse outcomes from HBV infection About 10% of adults who are infected with hepatitis B go on to chronic hepatitis, which lasts for years.Chronic hepatitis B eventually can cause scarring of the liver (known as cirrhosis), liver failure, and, more rarely, liver cancer.While these complications are uncommon, they serve to emphasize the need for proper techniques to prevent transmission of HBV. | View Page |
| Four scenarios will now be presented to evaluate your understanding of the material that has been presented on classifying, packaging, and labeling laboratory specimens for shipment. The scenarios are for your practice and will not be graded.Choose all the appropriate labels from the table below that must be used when packaging the substances described in the following scenarios:Scenario OneThree serum samples for hepatitis testing need to be sent via courier. The courier is an employee of your healthcare system. The specimens will be transported in a motor vehicle used exclusively for transporting specimens. What packaging labels are required? Choice Label Choice Label AGBH CIDJ EK FL | View Page |
| This suspicious form measures 15 µm and was recovered in stool. Which of the following conditions is/are associated with the presence of this form? | View Page |
| This suspicious form, recovered in stool, measures 12 µm in length. Which of the following conditions is this form responsible for causing when present? | View Page |
| Acute hepatitis panel Acute hepatitis panel:
Hepatitis A antibody (IgM)
Hepatitis B core antibody, IgM (HBcAb)
Hepatitis B surface antigen (HBsAg)
Hepatitis C antibody
| View Page |
| The peripheral blood picture is consistent with each of the following conditions except: | View Page |