GI: Hepatitis Flashcards
What are the pathological features of hepatitis?
Liver cell necrosis
Inflammatory cell infiltration
What is chronic hepatitis?
Inflammation of the liver lasting greater than 6 months
What causes chronic hepatitis?
Hep B, D, C
Autoimmune hepatitis
Wilson’s disease
Alcohol
How is Hep A spread?
Faecal-oral
Associated with poor hygiene, overcrowding
What age group most commonly gets Hep A?
Children and young adults
How is Hep A diagnosed?
The presence of IgM anti-HAV in the blood
The presence of what antibody in the blood indicates past Hep A infection?
IgG anti-HAV
How is hep B spread? What is it associated with?
Blood-blood
Sex
mother-child
Gay/polygamous sex and IV drug users
Which antigen in hep B is present in all infectious individuals?
HBsAG (surface antigen)
How long does HBsAG have to be present in the blood for the infection to be classified as chronic?
6 months
Which antigen is generally present in patients with highly infectious hepatitis B?
HBeAG
The presence of which Hep B antigen indicates acute infection?
IgM anti-HBc
Which form of hepatitis is only found in conjunction with hepatitis B?
Hepatitis D- exacerbates hep B
How is hep C spread? What is it associated with?
Blood-Blood
Sex
IV drug use
Which antigen is present in individuals who have previously been infected by or immunised against Hep B?
Anti-HBs
Which form of hepatitis cannot be vaccinated against?
Hepatitis C
How is hepatitis E spread?
Faecal-oral
Zoonosis
Person-person in immunocompromised individuals
Which two combined treatments provide the best outcome for patients with Hep C?
Peginterferon and ribavarin
What are the side effects of peginterferon?
Flu like symptoms
Are antivirals used in acute or chronic hepatitis infection?
Chronic
What immunological abnormalities are seen in autoimmune hepatitis?
Hypergammaglobulinaemia
High IgG levels
Circulating antibodies
Plasma cell infiltration on biopsy
Which circulating antibody indicates autoimmune hepatitis?
ASMA (anti-smooth muscle antibodies)
What are the signs and symptoms of autoimmune hepatitis?
Symptoms: malaise, anorexia, nausea, fatigue
Signs: spider naevi, palmar erythema, jaundice, hepatosplenomegaly
How is autoimmune hepatitis treated?
prednisolone 2-3 weeks lifelong Azathioprine (immunosuppressant)