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R - Infections (Unknown) > HEpatitis > Flashcards

HEpatitis Flashcards

1
Q

How are each of the hepatitis viruses transmitted?

A

Most can be transmitted parenterally i.e. by IVDA or blood products (except E and A only rarely)

A & E are mostly Faecal-Oral

B & C can also be transmitted sexually & perinatally

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2
Q

How long does hepatitis take to incubate?

A

A - 28days
E - 40days
C - 60days
B - 90 days

D comes with Hep B

All have a wide range of incubation time so can come on as short as 10 days (A) or as long as 160 days (B & C)

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3
Q

What type of hepatitis is commonest in travellers & immigrants?

A

A, B & E

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4
Q

What type of hepatitis is commonest in IVDUs?

A

B, C & D (remember D comes with B)

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5
Q

What type of hepatitis is commonest in people with multiple sexual partners (esp MSM)?

A

B

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6
Q

What type of hepatitis can sewage workers get more of?

A

A

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7
Q

What type of hepatitis is most likely in healthcare workers?

A

B

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8
Q

What type of hepatitis is commonest in people recieiving blood products?

A

C

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9
Q

How often does hepatitis progress to chronic infection?

A

60-80% in Hep C

E will if immunocompromised

B rarely does

A never does

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10
Q

What types of hepatitis are likely to cause cirrhosis?

A

All except A can

E only if immunocompromised

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11
Q

What types of hepatitis are ass with hepatoma formation?

A

B & C

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12
Q

How do you diagnose hepatitis?

A

With viral serology so IgM & IgG

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13
Q

Which hepatitis does not have detectable IgM Abs?

A

C

You can do Antigen and RNA detection

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14
Q

What vaccines are available for each hepatitis?

A

Inactivated vaccine for A (only if in a high risk group)

Recombinant vaccine for B
(also covers D)

No vaccine available for C & E (e is available in china)

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15
Q

What passive immunisation can we offer for hepatitis?

A

To people with exposure risk such as close contacts of a Hep sufferer:

a = Human Normal IG

B = Hep B IG

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16
Q

Which hepatitises are DNA vs RNA?

A

All are RNA viruses except B

17
Q

What symptoms tend to come with hepatitis?

A
  • Fever
  • Anorexia
  • Fatigue/lethargy
  • N&V
  • Abdo pain
  • Jaundice

Can also suffer from arthralgia, urticaria

Fulimative hepatitis can result in complications such as encephalopathy, DIC etc.

18
Q

How do we treat Hep A?

A

Supportively, most will eventually recover with no lasting damage

19
Q

How do we treat Hep B?

A

Antiviral:

  • Pegylated alpha-interferon SC for 12 months
  • 5 Nuceloside analogues e.g. Tenofovir
20
Q

How do we treat Hep C?

A

Pegylated Alpha-interferon

Ribavarin

21
Q

Treating Hep D?

A

Pegylated Alpha-interferon

22
Q

How do we treat Hep E?

A

Often found in the immunocompromise so minimising/reversing this may be all that’s needed

Also Ribavirin

23
Q

How do we prevent hepatitis infections?

A

Screen all blood products
Screen liver transplants
Passive & Active immunisation
Hygiene

Encouraging safe sex & needle use

24
Q

What happens to a healthcare worker who’s Hepatitis +ve?

A

Not allowed to perform Exposure Prone Procedures(EPPs)

25
Q

As a healthcare worker what should you do after percutaneous exposure to blood/bodily fluids?

A

1) Encourage bleeding
2) Wash thoroughly with hot running water and soap
3) Waterproof plaster
4) Report to supervisor

26
Q

How do we manage risk of BBVs in an exposed healthcare worker?

A

Testing of the source patient

Counselling
Store blood at time of injury
Testing at 3 & 6 months

Active or passive immunisation depending on immunisation history

27
Q

What are the different types Hep B Antigen?

A

HbsAg = used for identifying acute & chronic infection

HbcAg indicates recent infection

HbeAg & HBV-DNA both indicate actively replicating virus

28
Q

At what point is Hep B considered Chronic?

A

When HbsAg is detectable for >6months

29
Q

What percentage of people with Hep B become chronic?

A

Infants = 90%
Kids = 40%
Adults - 5-10%

30
Q

What’s the particular danger of Hep B patients with prolonged HbsAg & HbeAg?

A

At a higher risk of sequelae incl:

  • Chronic liver disease
  • Cirrhosis
  • Hepatoma
31
Q

Who should be vaccinated against Hep B?

A
  • Healthcare workers
  • Close contacts
  • Some police/emergency services
  • IVDUs
  • MSM & sex workers
  • Some chronic liver disease/renal failure
  • Inmates
32
Q

What’s the big danger of Hep c?

A

Has the highest rate of progression to chronic liver disease & cirrhosis (60-80%)

33
Q

What tests can you do for Hep C other than IgM?

A

Serum ALT for liver damage

HCV RNA

34
Q

How can we prevent transmission to neonates?

A

Treat mom

Give immediate active & passive immunisation to neonate after birth

35
Q

I’ve only covered what I found to be the most important stuff as exams are in 7 days (LUL)

A

So i’d advise reading the booklet if you have time

R - Infections (Unknown) (16 decks)

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