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Hepatology > Acute Viral Hepatitis > Flashcards

Acute Viral Hepatitis Flashcards

1
Q

Comapre between hepatotropic and non hepta viruses

A
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2
Q

Most serious form of viral hepatitis

A

Fulminant hepatitis

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3
Q

Most common form of viral hepatitis

A

Icteric hepatitis

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4
Q

Mention clinical form of hepatitis with coma jaundice bleeding

A

Fulminant

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5
Q

Epidemic vital hepatitis

A

Asymptomatic

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6
Q

Gastro entritis with no jaundice hepatitis

A

Anictric

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7
Q

What are the hepatotropic viruses that cause acute viral hepatitis?

A

Hepatitis A, B, C, D, and E

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8
Q

Which non-hepatotropic viruses are associated with acute viral hepatitis?

A

Cytomegalovirus (CMV), HSV, and Epstein-Barr virus (EBV)

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9
Q

What is the transmission method for Hepatitis A (HAV)?

A

Feco-oral

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10
Q

What is the incubation period for Hepatitis A (HAV)?

A

2-6 weeks

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11
Q

What diagnostic test is used for Hepatitis A (HAV)?

A

Anti-HAV - IgM

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12
Q

Is there a vaccine available for Hepatitis A (HAV)?

A

Yes

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13
Q

Does Hepatitis A (HAV) lead to chronicity?

A

No

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14
Q

What is the treatment for Fulminant Hepatitis caused by HAV?

A

No

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15
Q

What type of virus causes Hepatitis B (HBV)?

A

DNA (Hepadnavirus)

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16
Q

What are the transmission methods for Hepatitis B (HBV)?

A

Parenteral, Sexual, Vertical

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17
Q

What is the incubation period for Hepatitis B (HBV)?

A

2-6 months

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18
Q

What diagnostic test is used for Hepatitis B (HBV)?

A

Anti-HBc IgM + s Ag

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19
Q

Is there a vaccine available for Hepatitis B (HBV)?

A

Yes

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20
Q

Does Hepatitis B (HBV) lead to chronicity?

A

Yes

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21
Q

What is the treatment for Hepatitis B (HBV)?

A

Interferon α

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22
Q

What type of virus causes Hepatitis C (HCV)?

A

RNA (Flavivirus)

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23
Q

What are the transmission methods for Hepatitis C (HCV)?

A

Parenteral, Sexual, Vertical

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24
Q

What is the incubation period for Hepatitis C (HCV)?

A

1-5 months

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25
Q

What diagnostic test is used for Hepatitis C (HCV)?

A

HCV RNA by PCR

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26
Q

Is there a vaccine available for Hepatitis C (HCV)?

A

No

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27
Q

Does Hepatitis C (HCV) lead to chronicity?

A

Yes (80% of cases)

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28
Q

What is the treatment for Hepatitis C (HCV)?

A

Peg-interferon

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29
Q

What is the most common form of acute hepatitis?

A

Icteric hepatitis

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30
Q

What are the symptoms of pre-icteric phase in icteric hepatitis?

A

Mild fever, vomiting, abdominal pain, anorexia

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31
Q

What characterizes the icteric phase of icteric hepatitis?

A

Jaundice appears, liver is enlarged and tender, dark urine

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32
Q

What occurs during the convalescence phase of icteric hepatitis?

A

Liver decreases in size, jaundice gradually fades

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33
Q

What characterizes anicteric hepatitis?

A

No jaundice, common in infancy, symptoms include vomiting, diarrhea, colics, anorexia

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34
Q

What symptoms are associated with cholestatic hepatitis?

A

Jaundice, itching, clay-colored stool

35
Q

What is the most serious form of acute hepatitis?

A

Fulminant hepatitis

36
Q

What are the key presentations of fulminant hepatitis?

A

Bleeding, progressive jaundice, coma

37
Q

What is the mortality rate associated with fulminant hepatitis caused by HBV and HDV?

38
Q

What are the common symptoms of Hepatitis A?

A

Mild fever, vomiting, abdominal pain, anorexia, or may be asymptomatic, or picture of icteric hepatitis

Icteric hepatitis refers to jaundice, a yellowing of the skin and eyes due to bilirubin accumulation.

39
Q

What is a complication of Hepatitis A?

A

Cholestasis (clay-colored stools)

Cholestasis is a condition characterized by impaired bile flow.

40
Q

How do Hepatitis B and C often present clinically?

A

Asymptomatic in many cases

Hepatitis B and C can show similar symptoms to Hepatitis A but often go unnoticed.

41
Q

What are the potential complications of Hepatitis B and C?

A
  • Chronic hepatitis
  • Cirrhosis
  • Carcinoma
  • End stage liver disease
  • Fulminant hepatitis with B & D infections

Fulminant hepatitis is a rapid and severe form of hepatitis.

42
Q

What are the modes of transmission for HBV?

A
  • Perinatal transmission from carrier mothers
  • Blood transfusions
  • Needle stick injuries
  • Biting insects
  • Renal dialysis
  • Horizontal spread within families

Perinatal transmission is often referred to as vertical transmission.

43
Q

What is the nature of the Hepatitis D virus (HDV)?

A

A defective RNA virus that depends on hepatitis B virus for replication

HDV can cause acute exacerbation of Hepatitis B virus.

44
Q

What are the diagnostic investigations for acute hepatitis focused on?

A

Diagnosing liver cell injury

Investigations typically include liver function tests and bilirubin levels.

45
Q

What indicates liver cell injury in hepatitis diagnostics?

A
  • Increased bilirubin (Direct or Mixed Hyperbilirubinemia)
  • Raised liver enzymes: AST and ALT (usually increased from 10 folds)
  • Prolonged Prothrombin Time (normal 12 - 14 seconds)

AST is Aspartate aminotransferase and ALT is Alanine aminotransferase.

46
Q

What are the indicators of acute liver cell failure?

A
  • Increased bilirubin (Total ‘early’ & Direct ‘late’)
  • Raised liver enzymes (AST and ALT usually increased from 10 - 100 folds)
  • High International Normalized Ratio (INR) > 2 not corrected by Vitamin K
  • Blood ammonia level > 150 mcg/dl
  • Serum albumin < 3 gm/dl
  • Electrolyte disturbances (Hypoglycemia, Hyponatremia, Hypokalemia, metabolic acidosis)

Encephalopathy is a condition that affects the brain, often seen in severe liver failure.

47
Q

True or False: Hepatitis D virus can cause an acute exacerbation of Hepatitis C.

A

False

HDV specifically requires HBV for its replication.

48
Q

Fill in the blank: The prolonged Prothrombin Time in acute liver failure is typically _______.

A

> 2 not corrected by Vitamin K

Prothrombin Time is a measure of how well and how quickly your blood clots.

49
Q

What imaging study can demonstrate cerebral edema in acute hepatic encephalopathy?

A

CT scan

Cerebral edema is swelling in the brain, which can occur due to severe liver dysfunction.

50
Q

What are the common electrolyte disturbances in acute liver failure?

A
  • Hypoglycemia
  • Hyponatremia
  • Hypokalemia
  • Metabolic acidosis

These disturbances can lead to various complications and symptoms in patients.

51
Q

What is the incubation period for Hepatitis B?

A

Variable, typically 30 to 180 days

The incubation period can vary significantly among individuals.

52
Q

What does HBsAg indicate?

A

Infection

HBsAg stands for Hepatitis B surface antigen.

53
Q

What are the three antigens associated with Hepatitis B?

A
  • HBsAg (Surface antigen)
  • HBeAg (Envelope antigen)
  • HBcAg (Core antigen)

HBcAg is not present in blood, only in liver biopsies.

54
Q

What does the presence of HBeAg indicate?

A

High infectivity

HBeAg indicates that the virus is actively replicating.

55
Q

What are the antibodies associated with Hepatitis B recovery?

A
  • Anti-HBs (surface antibodies)
  • Anti-HBc IgG (core antibodies)

These antibodies indicate immunity after recovery.

56
Q

What does Anti-HBc IgM indicate?

A

Acute (recent) infection

Anti-HBc IgM is typically present during the initial phase of infection.

57
Q

What are the markers for Hepatitis A acute infection?

A

IgM antibodies to hepatitis A (anti-HAV IgM)

This indicates a recent infection with Hepatitis A.

58
Q

What is the primary method to detect Hepatitis C?

A

Anti-HCV antibodies

These antibodies indicate exposure to the Hepatitis C virus.

59
Q

What does a quantitative PCR test measure in Hepatitis C?

A

Viral load

This test is used to assess the treatment effect.

60
Q

What indicates recovery or immunity from Hepatitis A?

A

IgG antibodies to hepatitis A (anti-HAV IgG)

There is no chronicity associated with Hepatitis A.

61
Q

What is the window period in Hepatitis B?

A

Equivalence zone

This period occurs when neither HBsAg nor Anti-HBs are detectable.

62
Q

True or False: Hepatitis D virus is a defective virus that depends on Hepatitis B virus.

A

True

Hepatitis D cannot replicate without the presence of Hepatitis B.

63
Q

What type of virus is Hepatitis B?

A

Partially double-stranded DNA virus

This structure is significant for its replication and infection mechanisms.

64
Q

What is the primary method of case isolation for Hepatitis A?

A

From school or work during the infectivity period, 7 days after onset of jaundice.

65
Q

What are two important hygienic measures to prevent Hepatitis A?

A

Hand washing after changing diapers and before preparing food.

66
Q

What are the primary sources of transmission for Hepatitis B and C?

A

Blood borne.

67
Q

What screening is recommended for blood and blood products in relation to Hepatitis B and C?

A

Screening of blood & blood products like plasma, cryo, and platelets.

68
Q

What is the recommended practice for syringes to prevent Hepatitis transmission?

A

Use of disposable syringes (used once).

69
Q

Who should be screened for HBsAg and HCV antibody?

A

Pregnant mothers.

70
Q

What vaccinations are available for Hepatitis A?

A

Potent Inactivated Hepatitis A vaccine (Noncompulsory) with 2 doses, 6 months apart.

71
Q

What is the prophylaxis for Hepatitis A if vaccinated within 2 weeks of illness?

A

Immunoglobulin IM.

72
Q

What is the vaccination schedule for infants born to HBV positive mothers?

A

Both Vaccine & Immunoglobulins at birth.

73
Q

What is the dosage of anti-HBV immunoglobulins for exposure to needle sticks?

A

0.06 ml/kg IM.

74
Q

What supportive measures are recommended for patients with hepatitis?

A

Bed rest, proper nutrition (low fat & protein diet), avoid hepatotoxic drugs, symptomatic treatment.

75
Q

What symptomatic treatment is suggested for fever and vomiting in hepatitis patients?

A

Paracetamol.

76
Q

True or False: There is a vaccine available for Hepatitis C.

77
Q

What is the vaccination requirement for Hepatitis D?

A

Vaccination against Hepatitis B.

78
Q

When hepatitis is more likely mild fever and anorexia so it may be

A

Hepatitis a

79
Q

Fluctuating liver enzymes in hepatitis

80
Q

Mention diagnostic inv for fulminant hepatitis

81
Q

How to differentiate between hepatitis b vaccine and infection

A

Ab against core ag

82
Q

Metion the antibodies during acute, chronic , recovery from infection

83
Q

How to detect HBag c

A

By liver biopsy not present in blood

Hepatology (5 decks)

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