Gastroenterology 4 - Hepatitis Flashcards
5 causes of hepatitis
alcohol fatty liver disease viral autoimmune drug-induced (paracetamol)
7 features of hepatitis (can be asympto)
abdo pain itch jaundice fatigue muscle aches nausea, vomiting fever if viral
summarise hepatitis A to E
A - RNA, faecal oral, 1-3 month recovery, vomiting + cholestatic symptoms
B - DNA, vertical route, fluids, 80% clear it
C - RNA, fluid transmission, 75% becomes chronic (HCC big issue)
D - coinfector with B, worsens complications
E - rare here, another faeco-oral RNA virus, mild
meaning of Hep B viral panel HBsAg HBeAg HBcAb HBsAb HBV DNA
active infection!
HBsAg - surface antigen
HBeAg - marker of replication, shows infectivity
HBV DNA - viral load
HBcAb - past or current inf
HBsAb - cleared infection or vaccinated
general management Hep B virus
screen other blood borne viruses refer to specialists notify PHE stop smoking, alcohol educate on transmission screen complications
general management Hep C virus
HepC Ab screens if had it / got it
Hep C RNA shows viral load + genotype
Directly acting antivirals cure in 90% of people over 2-3 months
other management as with Hep B but screening for HCC even more important
autoimmune hepatitis type 1 + 2 summarise
it’s rare
type 1 - menopausal lady, jaundiced
type 2 - late teens
raised ALT, AST, IgG
type 2 has the more niche antibodies
give pred then azathioprine
