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Year 3 Abdo Conditions > Acute Hepatitis > Flashcards

Acute Hepatitis Flashcards

1
Q

Use the VITAMIN CDE surgical sieve to list the cuases of acute hepatitis?

A

VITAMIN CDE
1) Vascular = Ischaemic hepatitis (hypotension)

2) Infectious = Hep A, B, C, E, malaria, yellow fever, syphilis

3) Trauma =
- Paracetamol overdose
- alcohol abuse

4) Autoimmune

5) Metabolic
- Gall stone obstruction CBD

6) Iatrogenic
- Drugs e.g. amoxicillin

7) Neoplastic

8) Congenital
- Wilson’s disease
- haemochromatosis

9) Degenerative
- Cirrhosis

10) environement / endocrine

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2
Q

Who is affected by hep A virus?

A

children and young adults

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3
Q

What is the route of transmission of hep A

A

faecal-oral
shellfish
saliva

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4
Q

What is the incubation period of Hep A

A

2-3 weeks

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5
Q

What is the outcome of a hep A infection?

A
  • cholestatic Jaundice

- DOES NOT progress to chronic hepatitis

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6
Q

Where is Hep B found?

A

Hep B is more common in africa, middle east and asia.

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7
Q

How is Hep B transmitted?

A
  • blood products
  • faecal-oral
  • vertical (mother to child)
  • sexual
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8
Q

What is the incubation period of Hep B?

A

1-5 Months (long)

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9
Q

Who is at risk of a Hep B infection

A
  • men who have sex with men
  • low socio-economic
  • IVDU
  • learning difficulties
  • health workers
  • prison workers
  • traveller
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10
Q

Hep B can lead to chronic hepatitis - what are the complications of this?

A
  • Cirrhosis

- hepatocellular carcinoma

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11
Q

What are the prodromal symptoms of viral hepatitis?

A
  • fever
  • malaise
  • nausea
  • anorexia
  • arthralgia (hep B)
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12
Q

How is Hep C transmitted?

A
  • mainly via blood products
  • saliva
  • sex
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13
Q

What is the incubation period of hep C?

A

9 weeks (long)

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14
Q

Who is at risk of a Hep C infection?

A
  • haemophiliacs
  • thalassaemics
  • haemodialysed
  • IVDU
  • transplant
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15
Q

What % of hep C patients develop chronic hepatitis?

A
  • 50%
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16
Q

What are the icteric symptoms of hepatitis?

A
  • Jaundice
  • Hepatic encephalopathy
  • Pruritis
  • Steatorrhea
  • Dark urine
  • Transient rash
17
Q

Which hepatitis viruses progress to be chronic?

A
  • Hep B
  • Hep C
  • Hep D

(Hep A , and Hep E not chronic)

18
Q

What are the examination signs of hepatitis?

A
  • liver flap
  • Jaundice in sclera
  • tenderness RUQ
  • Hepatomegaly
  • Splenomegaly
19
Q

What investigations are done for acute hepatitis?

A
  • LFTs
  • Coagulation screen
  • FBC
  • U+Es
  • CRP / ESR
  • Coomb’s +ve haemolytic anaemia

VIRAL MARKERS:

  • IgM
  • Anti- HAV IgM
  • HBsAg surface antigen
  • HBeAg antigen
20
Q

What do the LFTs in acute hepatitis show?

A
  • raised serum bili
  • raised AST
  • Low ALP
  • raised ALT
21
Q

What does the coagulation screen show in acute hepatitis?

A
  • Increased prothrombin time
22
Q

What does the FBC show for acute hepatitis?

A
  • raised MCV (alcohol)
  • ## reduced WBC
23
Q

What antibodies will be raised in acute hepatitis?

A
  • IgM

Hep A:
- Anti-HAV Igm +ve (shows acute infection)

Hep B:

  • HBsAg surface antigen
  • HBeAg antigen
24
Q

What hep viruses can you get vaccinated against?

A

Hep A and B

25
Q

What are the pre hepatic causes of jaundice?

A
  • malaria
  • sickle cell
  • thalassaemia
26
Q

What are the intrahepatic causes of jaundice?

A
  • EBV
  • CMV
  • paracetamol overdose
  • Gilbert’s syndrome (can’t conjugate bilirubin)
  • liver cancer
27
Q

What are the post hepatic causes of jaundice?

A
  • gallstones
  • pancreatitis
  • pancreatic cancer
  • primary sclerosing cholangitis
28
Q

What is the treatment for viral hepatitis?

A
  • interferon
  • Iamivudine
  • entecavir
  • adefovir
29
Q

What are the complications viral hepatitis?

A
  • hepatic failure
  • cirrhosis
  • liver cancer (Hep B, C, D)
  • arteritis
  • vasculitis
  • AKI
  • hepatic encephalopathy
  • liver abscess

Year 3 Abdo Conditions (24 decks)

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