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Systems 2nd Year: Infection > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

Viral Hepatitis is a disease which

A

should be notified to health protection

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2
Q

what is the mean incubation period in hepatitis a

A

28 days

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3
Q

how many days after initial symptoms in hep a does jaundice present

A

3-10 days

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4
Q

why does urine become dark in hepatitis

A

conjugated bilirubin

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5
Q

how is hepatitis a spread

A

faecal oral route

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6
Q

when are patients infectious in jaundice

A

a week before onset of jaundice

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7
Q

what type of virus is Hep A

A

Picornavirus - RNA

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8
Q

which antibodies are present in serum for hep A

A

IgM

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9
Q

how long does it take for hep A antibodies to decline

A

3-6 months

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10
Q

treatment for hep a

A

none

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11
Q

Acute clinical hepatitis may occur when after infection with HBV

A

Few Weeks to 6 Months

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12
Q

What type of virus is hep b virus

A

Hepadnavirus

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13
Q

what are markers of viral replication in Her B

A

Serum HbeAg and HBV-DNA

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14
Q

what is major marker for identifying acutee and chronic HBV infection

A

HbSAg

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15
Q

which patients are highly infectious and at risk of developing chronic liver disease and primary liver cell cancer (hepatoma)

A

patients with HBeAg

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16
Q

Route of transmission in patients with Hep B

A

Vertical (Perinatal)

Horizontal (sexual, Parenteral eg Needlestick)

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17
Q

Transmission from family or person living close is form of what transmission in Hepatitis

A

Horizontal

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18
Q

Factors predisposing to increased risk of Hepatitis in UK

A
  1. Injecting Drugs
  2. Multiple Sexual Partners regardless of sexuality
  3. Immigration
  4. Learning Disability in Residential Care
  5. Haemodialysis Patients
  6. Haemophilia Patients
  7. when a sexual partner has risk factors
  8. Babies born to mothers with risks
  9. Tattooing or Body Piercing with Non Sterile
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19
Q

Babies born to mothers with what Hepatitis antigen are at high risk of perinatal infection and become chronically infected if no preventative immunisation given

A

HBeAg

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20
Q

Diagnosis of Acute HBV Infection can be made if

A

high levels of anti HbC IGM antibodies present

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21
Q

Chronic HBV Infection definition

A

Presence of HBsAg in serum for more than 6 months.

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22
Q

Who is particularly at risk of chronic HBV infection

A

infants
Male
Immunodeficient

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23
Q

what can chronic hbv infection lead to

A

chronic liver disease
membranous glomerulonephritis
Cirrhosis
Hepatoma

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24
Q

who is more likely to progress to chronic infection

A

Patients with asymptomatic or mild

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25
Q

Which Hepatitis complication is the third most common cause of cancer in world

A

Hepatoma

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26
Q

Treatment for Asymptomatic Chronic HBV Infection with Raised ALT HBeAG Positive and with Liver Disease or Cirrhosis

A

Anti Viral Therapy

27
Q

Indications for Antiviral for those without Cirrhosis 2 out of three of

A

HBV DNA >2000
Raised ALT
Significant Liver inflammation or fibrosis

28
Q

The active immunisation for Hepatitis contains

A

HbsAG

29
Q

When should you test for adequate protective antibody after immunisation in hepatitis

A

2-4 months after last dose

30
Q

How to tell further antibody checks not needed after immunisation

A

> 100 Post Vacine Anti Hbs

31
Q

When are boosters of Hepatitis vaccine needed

A

Every 5 Years

32
Q

What is a reliable indicator of liver inflammation in Hep C

A

ALT and Increasing AST

33
Q

Hep C is a type of which virus

A

Blood Borne

34
Q

Rate of transmission from mother to baby with Hep C is high when mother has

A

HIV

35
Q

Hep C mainly affects

A

injecting drugs
Haemophiliacs
Needle Stick
Blood Transfusion

36
Q

Hep C is in what virus family

A

RNA of Flavirus

37
Q

how to test for Hep C

A

Sequencing

38
Q

Treatment for Hep C

A

Pegylated A Interferon

Ribavirin

39
Q

Which hepatitis is always found in patients who have hepatitis B

A

Hepatitis D

40
Q

commonest mode of transmission for hep d

A

Parenteral Infection

41
Q

tests for hepatitis D

A

IgG

IgM

42
Q

treatment for hepatitis d

A

pegylated a interferon

43
Q

Symptoms develop in Hepatitis E how soon after incubation

A

40 days

44
Q

most common cause of acute viral hepatitis

A

Hepatitis E

45
Q

Hepatitis E is what type of virus

A

RNA Henevirus

46
Q

Hepatitis E tests

A

IgG and IgM and HEV

47
Q

When can healthcare workers with hepatitis not perform EPP

A

Hepatitis B Antigen Pos
Hep B surface Antigen Pos and HBV DNA of 1000 or more
Hep C Pos

48
Q

Which hepatitis viruses can be transmitted by the faecal-oral route?

A

Hep A and E

49
Q

How can these infections be prevented?

A

Hygiene, Clean Water, Immunisation (Hep A)

50
Q

. How is hepatitis Adiagnosed in the virus laboratory?

A

Detection of hepatitis A lgM antibody

in a serum sample.

51
Q

Which hepatitis viruses are spread by infected blood?

A

Heb B,C and D

52
Q

What is the purpose of testing serum for anti-HBc IgM antibody?

A

Its presence indicates recent hepatitis
B infection. If a patient is tested late in the course of illness, HBsAg may have disappeared but the presence of IgM-anti HBc indicates recent infection.

53
Q

Define chronic hepatitis B infection.

A

HBsAg is present in serum for at least 6 months.

54
Q

What percentages of people will become chronically infected following acute infection with HBV in i) infants ii) children iii) adults

A

i) 90% ii) 40% iii) 5-10%

55
Q

What is the clinical significance of prolonged HBsAg and HBeAg carriage?

A

Patients are at risk of long-term sequelae including chronic liver disease, cirrhosis and increased risk of hepatoma.

56
Q

What is the clinical importance of infection with hepatitis C?

A

60-80% of patients will show evidence of chronic liver disease and are at risk of progression to cirrhosis.

57
Q

What laboratory assessment would you make of someone with antibodies to HCV?

A

. Serum ALT, HCV RNA.

58
Q

What factor is essential for the transmission of hepatitis D?

A

Presence of HBsAg.

59
Q

What is the commonest mode of hepatitis D transmission?

A

Injection of Drugs

60
Q

History of recent jaundice in a 26 year old homosexual.

Hepatitis B surface antigen negative. Hepatitis B core antibody negative. Hepatitis A IgM positive.

A

MSM are at increased risk of hepatitis A as well as hepatitis B. Prevention of hepatitis A is possible by active immunisation with the killed vaccine.

Evidence for recent hepatitis A infection. No evidence for infection with hepatitis B.

61
Q

Antenatal screen in a 30 year old woman.

Hepatitis B surface antigen positive. Hepatitis B e antigen positive.
Hepatitis B e antibody negative. Hepatitis B core IgM antibody negative. Hepatitis B core total antibody positive.

A

Results consistent with chronic hepatitis B infection. The presence of surface antigen indicates infectivity. The presence of e antigen indicates high infectivity.
The absence of IgM anti-core indicates the infection is not recent.
Comment:
Arrangements should be made in advance so that active (hepatitis B vaccine) and passive (hepatitis B immunoglobulin) can be given immediately after birth to the neonate.
Follow up arrangements should be made
so that the infant gets the second dose of hepatitis B vaccine at age 4 weeks, the third dose at 8 weeks, and a fourth dose at 12 months, when hepatitis B serology (surface antigen) should also be checked to ensure the child is not infected.

62
Q

History of past injecting drug use.

Hepatitis A antibody negative
Hepatitis B surface antigen negative. Hepatitis B core total antibody positive. Hepatitis B surface antibody positive. Hepatitis C antibody positive.
Hepatitis C RNA positive.
5.

A

No recent or past infection with hepatitis A. Results consistent with past hepatitis B. Results indicate on-going hepatitis C infection.
Comment:
Both hepatitis B and C are common in PWIDs. Persistent infection is more common with hepatitis C than hepatitis B. Immunisation against hepatitis B is NOT indicated. Immunisation against hepatitis Ashould be offered. Assess suitability for hepatitis C treatment.

63
Q

Recent onset jaundice in a 65 year old diabetic man who has not been abroad recently.

Hepatitis A IgM negative.
Hepatitis B surface antigen negative. Hepatitis B core total antibody negative. Hepatitis C antibody negative.
Hepatitis E IgG antibody positive. Hepatitis E IgM antibody positive. Hepatitis E RNA positive

A

Results consistent with recent hepatitis E. No evidence for recent hepatitis Adetected. No evidence for infection with hepatitis B detected.
Comment:
Both hepatitis A and E may be acquired
in the UK (although HAV infection is now uncommon) and abroad. The incubation period of hepatitis E (mean 40 days) is longer than hepatitis A (mean 28 days). Remember to mention travel history on laboratory request forms.

64
Q

Going to live in Africa. Is immunisation needed?

Hepatitis A total antibody positive. Hepatitis B core total antibody negative

A

Evidence for past infection with hepatitis A. Immunisation not indicated.
No evidence for previous hepatitis B infection. Immunisation indicated.
Comment:
A person who plans to stay for a lengthy period in an area of high prevalence is in
a category for whom immunisation against both hepatitis Aand B should be considered. Immunisation against Yellow Fever and typhoid may also be indicated.

Systems 2nd Year: Infection (11 decks)

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