Acute Hepatitis Flashcards
Common causes of viral hepatitis
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
hepatitis E
Less common causes of viral hepatitis
Cytomegalovirus
Epstein bar virus
Rare causes of viral hepatitis
, herpes simplex, yellow fever
Clinical features of acute infection of the liver
Nonspecific prodromal illness
Headache
Myalgia
arthralgia
Nausea
Anorexia
2days -2 weeks after -> Jaundice with Dark urine ans pale stool
Liver tenderness,
mild hepatomegaly, splenomegaly, and cervical lymphadenopathy
Investigation of acute hepatitis
Liver function tests - high serum transaminase , plasmabilirubin for liver damage extent , ALP, prolongation of PT
FBC - relative lymphocytosis, normal wbc
Serological test for origin of infection
General management of acute hepatitis
Generally no hospital care
Avoid sedatives and narcotics
Avoid alcohol during a cute illness avoid elective surgery
Viral group of hepatitis A
Picornavirus group of enterovirus
Mean of transmission of hepatitis A
Fecal oral route
Population at risk of hepatitis A
Children,
people living in overcrowded and poor sanitation areas
Incubation time of hepatitis A
 2 to 6 weeks
Is there a chronic or carrier states in hepatitis A?
No
Main clinical presentation of ahepatitis A
Asymptomatic
Investigation of hepatitis A
Anti HAV antigen igM type titres
Management of hepatitis A
Improvement of social conditions, overcrowded and poor sanitation areas
active immunization
Which species is the only source of infection of hepatitis B?
Humans
Most common causes of chronic liver disease and hepatocellular carcinoma worldwide
Hepatitis B
Main clinical presentation of hepatitis B
Asymptomatic
What form of transmission of hepatitis B cause the highest risk of ongoing chronic infection
Vertical transmission from mother to child
Complication of chronic hepatitis b
Cirrhosis
hepatocellular carcinoma
Forms of hepatitis caused by hepatitis B
Acute hepatitis
Nonprogressive, chronic hepatitis
Progressive, chronic hepatitis with cirrhosis
Acute hepatic failure with massive liver necrosis
Healthy asymptomatic carrier
Incidence of hepatitis B in the world
1/3 of the world population
Amount of people worldwide with chronic hepatitis B infection
400 million people
Type of transmission of hepatitis B
Horizontal ( sexual ,needles, transfusion)
vertical
Investigation in hepatitis B
serology
PCR
Which factor is an indicator of active infection of hepatitis B?
HB surfàce antigen
When can you say after investigation that there is chronic hepatitis B
Serum HBsAg positive longer than six months
What does anti HBcAg ( core )
IgM indicates acute HBV infection
What does HBeAg indicates
Active Viral replication
Five phases of chronic hepatitis B
Immune tolerant phase
immune reactive, HBeAG positive, chronic hepatitis phase
inactive carrier phase
HBeAg negative,Chronic hepatitis phase
HBsAg negative phase
How do you measure viral loads?
Pcr
Management of acute hepatitis B
Monitoring for acute liver failure
Management of chronic hepatitis B
Oral antiviral to reduce viral load - direct acting nucleoside or nucleotide analogues (lamivudine , entecavir , tenofovir, interferon Alfa )
Liver transplant
Vaccine
Type of virus hepatitis C
RNA Flavivirus
Is acute symptomatic infection with hepatic c common or rare in pain
Rare
Percentage of people that develop chronic hepatitis C
80%
Is there active or passive protection against hepatitis c
No
People at risk of hepatitis c infection
IV. Drug abuse
multiple sex partners
surgery in past six months,
needlestick injury,
multiple contacts with HCV person,
employment in medical field
Unknown
Risk factors for progression from chronic hepatitis C to cirrhosis
Male gender
, immunosuppression like in HIV
prothrombotic states
heavy alcohol misuse
Percentage of people that develop cirrhosis after chronxi hepatitis for a long time within 20years
20%
Investigation in hepatitis C
Serum anti-HCV antibodies
Hepatitis c rna detection
Molecular analysis
LFT ( normal or fluctuating transaminases )
Liver histology by biopsy for liver fibrosis level
Management of hepatitis c
Eradicate infection by direct acting antiviral agents
Hepatitis E present in which countries
India
Middle East
Asia
France ( Europe )
Which disease does hepatitis E look like in terms of clinical presentation and management
Hepatitis A
How is hepatitis E different from hepatitis A?
Infection in Pregnancy associated with acute liver failure with high mortality