Hep B Flashcards
Story? Hep B
Middle aged Jaundice - eyes Nausea 2 weeks fatigue Low appetite and weight loss Abdo pain Arthralgia - painful joints
Why would a Hep B patient be jaundice?
Bilirubin is haem from old RBCs, it is usually carried by albumin to the liver, where it is conjugated into a water soluble substance, and broken down by bile from the bile duct before taken for excretion.
Hep B - Intrahepatic (liver) damage and extrahepatic (gall bladder) damage. Bilirubin must pass through both liver and gall bladder to be excreted, so there is a build up, leading to the characteristic ‘yellow’ jaundice.
Hep B - what is HbsAg?
Surface antigen, present when you are infected with Hep B.
Hep B - what is HbcAb?
Core antibody - present in anyone who has been infected with Hep B, acute, cleared or chronic.
Hep B - what is HbsAb?
Surface antibody - only appears when HIV sufferer is clear of infection.
What combination of antigens / antibodies will an acute HIV sufferer have?
HbsAg
HbcAb
May or may not have HbsAb
What combination of antigens / antibodies will a cleared HIV sufferer have?
No HbsAg
But HbcAb and HbsAb
What combination of antigens / antibodies will a chronic HIV sufferer have?
Yes - HbsAg and HbcAb
No - HbsAb
Investigations? Hep B
ALT / AST - liver damage
ALP - bile tract damage
Albumin
Coagulation e.g. PT, INR - clotting factors synthesised in the liver
Transmission? Hep B
Sexual contact
Drugs - needles
Household blood exposure
Vertical - 75% chance - worse if symptoms contracted young - problem in underdeveloped countries
Prognosis? Hep B
50% no symptoms
10% chronic - 90% if infected as children - cirrhosis, carcinoma
1% liver failure
Treatment? Hep B
No current cure
However 90% of adults do not develop the chronic disease
Vaccination - prevention - Produces surface antibody
Virus structure? Hep B
Double stranded
Enveloped
DNA
