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3. Inflammation > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

What is the incubation time for hepatitis A?

A

2-6 weeks, average of 28 days

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2
Q

Through what route does hepatitis A spread?

A

faeco-oral route and arises from the ingestion of contaminated food or water (e.g. shellfish)

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3
Q

How long do hepatitis A symptoms last for?

A

Symptoms usually last less than 2 months, although some people can be ill for as long as 6 months

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4
Q

What are classic symptoms for hepatitis A?

A
  • Fatigue
  • Fever
  • Nausea
  • Appetite loss
  • Jaundice
  • Dark urine
  • Diarrhea
  • Light or clay-colored faeces (acholic faeces)
  • Abdominal discomfort
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5
Q

How does hepatitis A relate to smoking and cigarette appetite?

A

Distate for cigarettes after infection

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6
Q

How is hepatitis A diagnosed?

A

HAV-specific IgM antibodies in the blood

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7
Q

What would LFTs show for a hepatitis A patient?

A

Raised ALT

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8
Q

What do IgM antibodies represent?

A

Acute infection

Low-titre –> chronic hep B

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9
Q

What do IgA antibodies represent?

A

Past infection, current immunity

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10
Q

How is hepatitis B transmitted?

A
  1. Vertical transmission

2. Horizontal transmission: children playing with same toy, IV drugs, male-male intercourse

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11
Q

In what body fluids can hepatitis B be found?

A

Saliva and semen

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12
Q

What causes the liver damage in hepatitis B infections?

A

The HBV is not directly cytopathic and liver damage is produced by the host cellular immune response

HBV-specific cytotoxic CD8 T cells recognise the viral antigen via HLA class I molecules on the infected hepatocytes

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13
Q

What would LFTs show for a hepatitis B patient?

A

Raised ALT

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14
Q

What are symptoms of acute infection with Hep B?

A

Malaise, loss of appetite, nausea, vomiting, body aches, mild fever, and dark urine, and then progresses to development of jaundice

The illness lasts for a few weeks and then gradually improves in most affected people

The infection may be entirely asymptomatic and may go unrecognised

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15
Q

What is the incubation time for hepatitis B?

A

30-180 days

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16
Q

What can chronic hep B lead to?

A

Cirrhosis

17
Q

What oncological risk does hep B infection carry?

A

hepatocellular carcinoma

Across Europe, hepatitis B and C cause approximately 50% of hepatocellular carcinomas

18
Q

How is Hep B diagnosed?

A

Based on markers of hepatitis B infection:

  1. Antigens of Hep B
  2. Antibodies against Hep B
19
Q

How would you manage acute hep B infection?

A

Symptomatic control

20
Q

How would you manage a chronic hep B infection?

A

Treatment with antiviral agents → Interferon, entecavir and tenofovir

Side-effects of treatment are many, with an acute flu-like illness occurring 6–8h after the first injection

21
Q

What is HBsAg?

A

Antigen for Hepatitis B: acute of chronic

22
Q

What is HBwAg?

A

Acute hepatitis B

23
Q

What would LFTs show for a CHRONIC hepatitis B patient?

A

LFT show moderate rise in aminotransferase and ALP

24
Q

What are indications for Hep B antiviral therapy?

A

Three criteria are used:

  1. serum HBV DNA levels
  2. serum ALT levels
  3. histological grade and stage
25
Q

What histology is related to Hep B?

A

Histologically, there is a full spectrum of changes from near normal with only a few lymphocytes and interface hepatitis to a full-blown cirrhosis

26
Q

What does anti-HBe indicate?

A

Seroconversion from Hep B pos to Hep B neg

27
Q

What percentage of people develops chronic Hep B?

A

Following an acute HBV infection, which may be subclinical, approximately 1–10% of patients will not clear the virus and will develop a chronic HBV infection.

28
Q

How is hepatitis C transmitted?

A

blood and blood products

High-risk groups: men who have sex with men, IV drugs, sex workers and attendees at STI clinics

29
Q

How does hep C present?

A

Most acute infections are asymptomatic, with about 10% of patients having a mild flu-like illness with jaundice and a rise in serum aminotransferas.

Most patients will not be diagnosed until they present, years later, with evidence of abnormal transaminase values at health checks or with chronic liver disease.

30
Q

What is the presentation of chronic hep C?

A

Fatigue is the commonest symptom with sometimes nausea, anorexia and weight loss, which do not correlate with disease activity.

31
Q

How do you treat chronic Hep C?

A

Pegylated interferon alpha

32
Q

What percentage of people with hep C develop chronic liver disease?

A

Some 85–90% of asymptomatic patients develop chronic liver disease. A higher percentage of symptomatic patients ‘clear’ the virus with only 48–75% going on to chronic liver disease

33
Q

What is the incubation time for Hepatitis C?

A

2 weeks to 6 months

34
Q

In hep C infections, what percentage of people is symptomatic?

A

20%

35
Q

What is the incubation time for Hepatitis D?

A

3-7 weeks

36
Q

What does hepatitis D need to infect someone?

A

A pre-existing Hep B infection, cannot exist without this

37
Q

How would you treat hep D?

A

Pegylated interferon alpha

38
Q

How is hepatitis D transmitted?

A

through broken skin (via injection, tattooing etc.) or through contact with infected blood or blood products

39
Q

What are the two types of hep D infections?

A
  1. Co-infection of HBV (clinically indistinguishable from an acute icteric HBV infection)
  2. Superinfection (results in an acute flare-up of previously quiescent chronic HBV infection)

3. Inflammation (21 decks)

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