4.4 Viral hepatitis Flashcards

1
Q

What type of virus is Hep A?

A

Non enveloped Simple enteric RNA virus

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2
Q

What type of virus is Hep B?

A

Blood borne enveloped DNA virus

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3
Q

What type of virus is Hep C?

A

Blood borne enveloped RNA flavivirus

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4
Q

What are the symptoms of acute hepatitis

A
Anorexia 
Nausea 
Vomiting 
Dark urine (bilirubinuria) 
Jaundice 
Tender soft liver 
Malasie and fatigue 
NO fevers, rigors or sore throat
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5
Q

How do you diagnose acute hepatitis?

A
Clinical illness 
History 
LFTs (ALT >500) 
Hepatitis serology 
Virology when you suspect HCV but not anti-HCV
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6
Q

What is the incubation of HAV?

A

3-6 weeks

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7
Q

What is the diagnosis of HAV?

A

IgM anti-HAV

IgG anti-HAV = past infection

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8
Q

What type of vaccination is HAV?

A

heat inactivated preparations of live attenuated virus with 2 injections over 6 months

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9
Q

What are the outcomes of HAV?

A

Acute hepatic flare is rare
Prolonged cholestasis in 5-10%
chronic infection does not exist

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10
Q

Indications for HAV vaccination?

A

Overseas travel
Occupation, family exposure
COmmunity outbreaks
patients with chronic liver disease: Heb B or C
Gamm globulin (ISG) for recent exposure or imminent overseas travel (< 4 week) - painful

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11
Q

How is HEV spread and what is the diagnosis?

A

enteric - waterborne

anti-HEV to diagnose

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12
Q

What does HBV express?

A

excess surface protein (HBsAg) can have negative HBeAg

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13
Q

What will you see in serology with HBV recovery?

A

HBsAg -
Anti-HBc + (core antibody = infection)
Anti-HBs (detected after vaccination)

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14
Q

What will you see in acute HBV serology?

A

HBsAg+
HBeAg+
HBV DNA very high

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15
Q

What happens with HBV in babies?

A

Effects usually mild but will be chronically infected

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16
Q

What happens with HBV in adults?

A

Conseuqences more severe than babies with 1% acute liver failure
Worse with increasing age and 2-5% chronicity

17
Q

Who is at most risk from HBV?

A

Immunosuppressed, older age, co infections with D and C, type 2 diabetes

18
Q

What are the consequences of chronic HBV?

A

Cirrhosis and HCC

  • After 30 risk depends mostly on HBV DNA level
  • Risk increases with serum HBV DNA >2000
19
Q

Which hepatitis infections can cause chronic hepatitis?

A

B and C

20
Q

Which hepatitis have vaccinations?

A

HAV, HBV, HEV

NOT HCV