Global Perspectives Flashcards

1
Q

Which hepatitis is a DNA virus?

A

Hep B

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2
Q

Which hepatitis types are spread by body fluids + blood?

A

Hep B + C

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3
Q

Which hepatitis types are food + water borne?

A

Hep A + E

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4
Q

Which hepatitis is only found in association with hep B?

A

Hep D

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5
Q

What are the signs and symptoms of acute hepatitis?

A
  • Fever, malaise
  • Nausea, vomiting, diarrhoea
  • Jaundice, dark urine
  • Right upper quad pain
  • Tender enlarged Liver
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6
Q

What is Hep A/E’s course and diagnosis?

A
  • Incubation 2-6 weeks
  • Anti HAV/HEV IgM = recent infection - persists 6 months
  • Anti HAV/HEV IgG = past infection/immunisation - remains for lifetime
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7
Q

How is Hep A vaccinated against?

A

Active - inactivated single dose IM injection, booster at 6 months > life long immunity
Passive - HNIG from someone with high titre anti-HAV IgG

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8
Q

How is Hep (B + D) & (C) transmitted and what are the risk groups?

A
Transmission 
- Horizontal + Vertical (C) 
- Blood transfusion 
- IV drug use, needle-stick 
- Sexual 
- Hospitals
Risk Groups 
- Children of mothers with chronic HBV/HCV
- Dialysis, organ transplant 
- Prisoners
- Drug injectors 
- Multiple sex partners
- Travelors to endemic region 
- Tattoos + piercings (C)
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9
Q

What is the course and diagnosis of Hep C?

A
  • Asymptomatic during acute stage
  • Most develop chronic
  • Silent killer > end stage LD decades after infection
  • Effective curative treatment available
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10
Q

What is the course of acute hepatitis?

A
  • Spontaneous viral clearance by immune system
  • Within weeks
  • Hep A, E, B (unless acquired in infancy)
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11
Q

What is the course of chronic hepatitis?

A
  • Viral persistance > 6months

- Hep B + C

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12
Q

What is the main complication of chronic viral hepatitis?

A
  • Liver fibrosis/cirrhosis
  • End stage LD = portal hypertension/ascites (low albumin = low osmotic pressure), bleeding oesophageal varices, liver failure
  • Hepatocellular carcinoma
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13
Q

What is the structure of Hep B?

A
  • HBsAg = surface antigen - used to gain entry into hepatocyte
  • HBcAg = core antigen - nucleocapsid
  • HBeAg = marker of high HBV replication
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14
Q

What lab diagnosis is used to detect acute HBV infections?

A

HBsAg
HBeAg
Anti-HBcAg IgM

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15
Q

What lab diagnosis is used to detect chronic HBV?

A

HBsAg
HBeAg
Anti-HBcAg IgG
Anti-HBeAg IgG

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16
Q

What lab diagnosis is used to detect HBV clearance?

A

-ve HBsAg
-ve HBeAg
Anti-HBsAg IgG = HBV immunity
Anti-HBcAg = past HBV infection

17
Q

What lab diagnosis is used to detect HBV immunisation?

A

-ve Anti-HBcAg (as only HBsAg in vaccine)

Anti-HBsAg IgG = HBV immunity

18
Q

What is the course and diagnosis of acute Hep B & D?

A
  • Incubation 6 weeks > 6 months
  • Detection HBsAg = infection
  • Anti-HBcAg IgM = acute
  • Anti-HBsAg IgG = viral clearance post vac
19
Q

What is the course and diagnosis of chronic Hep B?

A
  • Persistent HBsAg >6 months
  • HBeAg = high ifectivity
  • Younger exposure = more likely chronic
20
Q

How is Hep B vaccinated against?

A
Active
- HBsAg prepared in yeast
- 3 doses IM 
Passive
- HBIG

HBV immunisation also protects from HDV

21
Q

How is chronic HBV treated?

A

Antivirals - inhibit HBC reverse transcriptase + suppress viral replication

22
Q

How is Hep C diagnosed?

A

IgG antibodies

HCV RNA

23
Q

How is HCV treated?

A

Direct-acting antivirals

Blood cleared > 12 weeks = cured