Hepatitis Flashcards

1
Q

What does hepatitis describe?

A

Inflammation to the liver

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2
Q

Causes of hepatitis?

A

Alcoholic hepatitis
Non alcoholic fatty liver disease
Viral hepatitis
Autoimmune hepatitis
Drug-induced hepatitis (e.g. paracetamol overdose)

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3
Q

Presentation of hepatitis?

A

Abdominal pain
Fatigue
Pruritis
Muscle and join aches
Nausea and vomiting
Jaundice
Fever (viral hepatitis)

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4
Q

Typical LFT findings in hepatitis?

A

High AST/ALT with proportionally less rise in ALP

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5
Q

How is Hepatitis A transmitted?

A

Faecal-oral route

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6
Q

How long does it take for Hep A to resolve?

A

1-3 months

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7
Q

What type of virus is Hep A?

A

RNA

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8
Q

What type of virus is Hep B?

A

DNA

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9
Q

How is Hep B transmitted?

A

Direct contact with blood/bodily fluids

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10
Q

What percentage of people with Hep B go on to become chronic carriers?

A

10%

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11
Q

What antibodies indicate active infection?

A

HBsAg = surface antigen

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12
Q

What antibodies indicate previous infection?

A

HBcAb = core antibodies

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13
Q

If HBsAg and HBcAb are positive then what else should you test for?

A

HBeAg = E antigen - marker of viral replication and implies high infectivity

Viral load

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14
Q

What immunoglobulin implies active infection?

A

Active infection

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15
Q

What immunoglobulin implies past infection?

A

IgG where HBsAg is neg

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16
Q

What type of virus is Hepatitis C?

17
Q

How is Hep C spread?

A

Blood/body fluids

18
Q

Disease course of hep C?

A

1/4 fights infection and makes full recovery
3/4 becomes chronic

19
Q

Complications of Hep C?

A

Liver cirrhosis and hepatocellular carcinoma

20
Q

Treatment of Hep C?

A

Direct acting antivirals (DAAs) - successful cure in over 90% of patients. Typically taken for 8-12 weeks.
Liver transplant in end-stage disease

21
Q

What type of virus is Hep D?

22
Q

What infection does Hep D require its host to already be infected with in order to survive?

23
Q

What type of virus is Hep E?

24
Q

How is Hep E transmitted?

A

Faecal-oral route

25
Is Hep E serious?
Often only a mild illness, cleared within a month, no treatment required.
26
What are the 2 types of autoimmune hepatitis?
Type 1 - adults Type 2 - children
27
Typical patient with Type 1 autoimmune hepatitis?
Women in late 40s/50s, presenting around/after the menopause with fatigue and features of liver disease on examination
28
Typical patient with Type 2 autoimmune hepatitis?
Teens/early 20s with acute hepatitis with high transaminases and jaundice.
29
Autoantibodies associated with Type 1 autoimmune hepatitis?
Anti-nuclear antibodies (ANA) Anti-smooth muscle antibodies (anti-actin) Anti-soluble liver antigen (anti-SLA/LP)
30
Autoantibodies associated with Type 2 autoimmune hepatitis?
Anti-liver kidney microsomes-1 (anti-LKM1) Anti-liver cytosol antigen type 1 (anti-LC1)
31
How is autoimmune liver disease confirmed?
Liver biopsy
32
Treatment of autoimmune liver disease?
Prednisolone Azathioprine Transplant in end-stage liver disease However autoimmune hep can recur in transplanted livers