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infection > 8.1 Viral hepatitis > Flashcards

8.1 Viral hepatitis Flashcards

1
Q

Liver = …1… organ positioned in the ..2.. of the abdomen

A
  1. peritoneal
  2. right upper quadrant (RUQ)
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2
Q

List some functions of liver

A
  • Production of bile
  • Filtering of toxins
  • Excretion of bilirubin cholesterol/hormones/drugs
  • Breakdown of carbohydrates, fats, protein
  • Activation of enzymes
  • Storing glycogen, minerals, ADEK
  • Synthesise blood proteins
  • Synthesise clotting factors
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3
Q

hepatitis means ?

A

inflammation of liver

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4
Q

5 main types of hepatitis viruses ?

A
  • A
  • B
  • C
  • D
  • E
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5
Q

all viral hepatitis infections are ..1.. diseases

A

notifiable

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6
Q

Who would need to be notified about notifiable diseases apart from partner of an infected patient ?

A
  • Local health protection board member
  • CDC
  • health protection agency
  • UKHSA
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7
Q
A
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7
Q

Name some different strains that are included in enteroviruses [change Q]

A
  • group A and group B coxsackieviruses
  • the echoviruses
  • the plioviruses
  • hepatitis A virus
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8
Q

Normal site of replication for hepatitis

A

GI tract

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9
Q

When viral infection damages the liver what can be damaged ?

A

all of the liver’s essential functions

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10
Q

When may the symptoms of viral hepatitis occur ?

A
  • instant
  • or occur months or years after the infection itself
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11
Q

list symptoms of viral hepatitis

A
  • jaundice - yellowing of skins & eyes
  • abdominal pain & distention
  • dark urine
  • light coloured stool
  • vomiting
  • fatigue
  • weight loss
  • coma brought on by accumulation of waste products
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12
Q

When the host immune system responds to the infection within the liver cells the response ..1.. liver cells ands causes ..2..

A
  1. kills
  2. the liver damage
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13
Q

What can chronic hepatitis infection cause ?

A
  • permanent liver damage
  • liver failure
  • cancer
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14
Q

Virus type of hepatitis A virus ?

A

non-enveloped ss RNA virus

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15
Q

Hepatitis A infection replicates in ..1.. interfering with ..2… and causing ..3..

A
  1. hepatocytes
  2. cell function
  3. inflammation
16
Q

transmission of hepatitis A ?

A

faecal-oral route

17
Q

Hepatitis A transmission happens via …1…. often occurs in ….2… to places where the virus is ..3….

A
  1. contaminated foor or water
  2. travellers
  3. highly endemic
18
Q

Where are the highest risk areas for UK travellers for Hepatitis A ?

A
  • Indian sub-continent
  • sub-saharan africa
  • middle east
  • south east
  • east asia
19
Q

Why is infection uncommon among adults living in countries which are the highest risk areas for UK travellers for Hepatitis A ?

A

most people are exposed at a young age and acquire lifelong immunity

20
Q

Although HAV is uncommon in the UK, list some of the risk groups :

A
  • travel - those travelling to endemic areas
  • sexual - high risk activities, multiple partners, MSM, analingus
  • haematological disorders - factor 8 & 9 concentrates have been implicated in transmission
  • occupational risks - for example lab or sewage workers
  • IVDU - known to be at INC risk
21
Q

clinical features of hepatitis A infection ?

A
  • most children and 1/2 adults = asymptomatic
  • symptoms common to all acute viral hepatitis
22
Q

Illness type of hepatitis A infection is usually…?

A

self-limiting

23
Q

4 clinical phases of hepatitis A infection ?

A
  1. Incubation
  2. prodromal
  3. icteric
  4. convalescent
24
Q

Incubation phase of Hep A
1. days
2. symptoms

A
  1. ~ 30
  2. no symptoms
25
Q

prodromal phase of Hep A
1. days
2. symptoms

A
  1. 3-10
  2. flu-like symptoms, general fatigue, joint pain , low grade fever, GI symptoms e.g. nausea, vomiting , RUQ discomfort
26
Q

Icteric phase of Hep A
1. days
2. symptoms

A
  1. 1-3 weeks (can persist < 12 weeks)
  2. jaundice, pale stools, dark urine, pruritus (itching), hepatomegaly
27
Q

convalescent phase of Hep A
1. days
2. symptoms

A
  1. (up to 6 months)
  2. malaise, anorexia, muscle weakness, hepatic tenderness
28
Q

Investigations for Hep A ?

A
  • antibody testing - HAV IgM , HAV IgG
  • IgM detectable during acute infection (and slightly after), IgG persists
  • IgM positive, IgG positive - acute infection
  • IgM negative, IgG positive - vaccination or past infection
29
Q

Investigations for hepatitis A that isn’t antibody testing

A
  • liver function test - ALT (raised)
  • bilirubin (elevated)
  • ALP (elevated)
  • prothrombin time, clotting function tests (prolonged)
30
Q

management of hepatitis A ?

A
  • notify HPU
  • paracetamol / analgesia (not liver impairment)
  • anti emetics
  • provide information to patient e.g …
  • follow up: repeat LFTs & admit to hospital if seriously unwell
31
Q

Hepatitis A vaccine is recommended to who ?

A
  • those at risk of infection
  • at risk of complications of infection
32
Q

List individuals who should be offered vaccination for Hep A

A
  • travel (to endemic areas)
  • chronic liver disease
  • sexual (MSM, high risk activities)
  • occupational risks
  • IVDU

infection (29 decks)

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