3.13.3. Liver + Biliary Tree Disease - Viral Hepatitis - C Flashcards

1
Q

What causes Hepatitis C infection?

A

A Parenteral Virus (HCV)

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2
Q

How does HCV enter into the Bloodstream?

A

It is a Parenternal Virus -

Transmitted through Blood-Blood contact

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3
Q

How are most Blood-Blood (Parenternal )Viruses transmitted?

A
  1. I.V. Drug Abusers

2. Sex

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4
Q

What type of disease does HCV cause?

A

Chronic Liver Disease

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5
Q

What is the Structure of the Hepatitis C Virus?

A
  1. HCV RNA is contained within a Nucleocapsid (Inner Layer

2. The Nucleocapsid is contained an Envelope, containing Glycoproteins

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6
Q

What can be detected during Active Replication of the Hepatitis C Virus?

A

HCV RNA

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7
Q

What antibody is produced in response to HCV infection?

A

Anti-HCV

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8
Q

What does Acute HCV infection cause?

A

Inflammation of the Liver

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9
Q

What does exposure of HCV lead to?

A
  1. It being Resolved (in 15% of cases)
  2. It becoming Chronic Stable (in 80% of the Unresolved cases / 68% of Total Cases)
  3. It becomes Chronic Slowly Progressive / Cirrhotic (in 75% of the Chronic Unstable cases / 13% of Total Cases)
  4. It will develop into Hepatocellular Carcinoma (25% of the cases which are Slowly Progressive / 4% of Total Cases)
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10
Q

What are the Clinical Signs of HCV infection?

A
  1. Hepatomegaly
  2. Lymphadenopathy
  3. Deranged Enzymes
  4. Jaundice
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11
Q

Why does Hepatomegaly occur?

A

Due to the Inflammation of the Liver caused by the HCV infection

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12
Q

Why does Lymphadenopathy occur?

A

This is due to the Immune response to the HCV infection

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13
Q

Why do Deranged Enzymes appear?

A

Due to the potential impairment of the Hepatic Function

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14
Q

What type of Jaundice occurs?

A

Intrahepatic

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15
Q

Why does Jaundice occur?

A

Due to the damage of Hepatocytes, they cannot effectively deal with Bilirubin and so there is a back-up into the Blood

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16
Q

What are the Symptoms of HCV infection?

A
  1. Asymptomatic
  2. Nausea an Vomiting
  3. Anorexia
  4. Flu-like symptoms
17
Q

When will HCV remain Asymptomatic until?

A

Cirrhosis occurs

18
Q

Why does Nausea and Vomiting occur in an HCV infection?

A

Due to this being an infection of an Accessory Organ of the Alimenatry Tract, this is the body’s natural response

19
Q

Why does Anorexia occur?

A

Due to the associated Nausea and Vomiting

20
Q

Why do Flu-Like Symptoms occur?

A

Due to the presence of infection rapidly damaging Hepatocytes - this is the body’s natural reponse

21
Q

What investigations are necessary for HCV infection?

A
  1. Serum Inflammatory Markers (PCR and ESR)
  2. Serology (and ELISA)
  3. Abdominal Ultrasound / CT Scan
  4. Cirrhosis investigation
22
Q

What is the Serology (and ELISA) looking for?

A
  1. HCV RNA which indicates current infection

2. Anti-HCV Antibody which indicates there has been HCV infection

23
Q

What is the purpose of the Abdominal Ultrasound / CT Scan?

A

To view the liver to see if Cirrhosis has occurred

24
Q

What are the Treatments for HCV infection?

A
  1. Daclatasvir
  2. PEGylated Interferon
  3. Oral Ribavirin
25
Q

What is the action of Daclatasvir?

A

This inhibits the production of the HCV Non-Structural Protein, preventing successful replication

26
Q

What is the action of PEGylated Interferon?

A

This causes the T-Helper cells (associated with the infection) to become T2-Helper Cells, to invoke a quicker and more powerful immune response

27
Q

What is the action of Oral Ribavirin?

A

This makes the native drug resemble Adenosine / Guanosine which is incorporated into the RNA and is fatal to the Virus

28
Q

What can occur in advanced stage HCV infection?

A

Liver Cirrhosis