hepatitis

Question 1

causes

Answer 1

alcoholic hepatitis
NAFLD
viral 
autoimmune 
drug induced e.g. paracetomal overdose

Question 2

presentation

Answer 2

abdo pain 
fatigue 
pruritis
myalgia 
N+V
jaundice
fever (if viral)

Question 3

typical LFT findings

Answer 3

raised transaminases

raised bilirubin

Question 4

hepatitis A - route of transmission

Answer 4

faecal-oral route

Question 5

hepatitis A - presentation

Answer 5

nausea + vomiting 
anorexia
jaundice 
dark urine + pale stools 
hepatomegaly

Question 6

hepatitis A - clinical course

Answer 6

resolves w/o treatment in ~1-3mo

Question 7

hepatitis A - Mx

Answer 7

analgesia

vaccination for prevention

Question 8

hepatitis A - type of virus

Answer 8

RNA

Question 9

hepatitis B - type of virus

Answer 9

DNA virus

Question 10

hepatitis B - route of transmission

Answer 10

direct contact with blood/bodily fluid

sex
sharing needles
vertical transmission

Question 11

hepatitis B - clinical course

Answer 11

most people fully recover within 2mo

10% go on to become chronic hepB carriers

Question 12

hepatitis B viral markers - surface antigen (HBsAg)

Answer 12

indicates active infection

Question 13

hepatitis B viral markers - HBeAg

Answer 13

E antigen

marker of viral replication, implies high infectivity

Question 14

hepatitis B viral markers - HBcAb

Answer 14

core antibodies

implies past or current infection

Question 15

hepatitis B viral markers - HBsAb

Answer 15

surface antibody

implies vaccination or past or current infection

Question 16

hepatitis B viral markers - HBV DNA

Answer 16

direct count of viral load

Question 17

hepatitis B screening: previous infection

Answer 17

HBcAb

Question 18

hep B screening - active infection

Answer 18

HBsAg

Question 19

how can HBcAb differentiate between acute, chronic and past infections

Answer 19

IgM implies active infection: high titre if acute and low titre if chronic

IgG indicates past infection where HBsAg is negative

Question 20

hep B vaccination

Answer 20

test for HBsAb to confirm response

3 doses

included in 6in1

Question 21

hep B management

Answer 21

• low threshold for screening those at high risk
• screen for other blood borne viruses and STDs
• notify public health
• antiviral medication

Question 22

Hep C - virus type

Answer 22

RNA virus

Question 23

Hep C - route of transmission

Answer 23

blood and bodily fluids

Question 24

Hep C - vaccination

Answer 24

none available

Question 25

Hep C - disease course

Answer 25

1 in 4 make full recovery 3 in 4 become chronic

Question 26

Hep C - complications

Answer 26

liver chirrosis | hepatocellular carcinoma

Question 27

Hep C - testing

Answer 27

Hep C antibody = screening test HCV RNA to confirm diagnosis, calculate viral load and assess genotupe

Question 28

Hep C - Mx

Answer 28

direct acting antivirals

Question 29

Hep D - virus

Answer 29

RNA virus can only survive in patients with HBV

Question 30

hep E - virus type

Answer 30

RNA

Question 31

hep E - route of transmission

Answer 31

faecal oral route

Question 32

hep E - clinical course

Answer 32

usually produces mild illness + is cleared in a month without treatment needed rarely progresses to chronic (more so in immunocompromised)