Hepatitis

Question 1

What is the main manifestation of hepatitis viruses?

Answer 1

Liver disease

Question 2

How is hepatitis A spread?

Answer 2

Faecal/oral route

Question 3

Where is hepatitis A present?

Answer 3

Faeces - mainly

Urine - to a lesser extent

Not spread through blood contact

Question 4

How do young children often present with hepatitis A?

Answer 4

They are often asymptomatic

Question 5

At which age bracket is hepatitis A likely to be symptomatic?

Answer 5

Older children to young adults

Question 6

Which coloured blood bottle (vial) top is used for blood samples to test for any type of hepatitis?

Answer 6

Yellow

Question 7

Which antibody class can be detectable for hepatitis A?

Answer 7

IgM

Question 8

Where is hepatitis E most common?

Answer 8

Tropics

Question 9

How is hepatitis E spread?

Answer 9

Faecal/oral route

Question 10

Hepatitis E is a zoonosis

True or false

Answer 10

True

It can be a zoonosis and this is often expected for cases in the UK

In the tropics it can spread from person to person

Question 11

Is there a vaccine for hepatitis E?

Answer 11

No

Question 12

When can hepatitis D be present?

Answer 12

Only with hepatitis B

Question 13

How is hepatitis B transmitted?

Answer 13

1. Sex
2. Mother to child
3. Blood

Question 14

Tattoos, use of needles for drug use and unscreened transfusions are all indicative of which type of hepatitis?

Answer 14

B and C

Question 15

How does the risk of acute versus chronic infection differ with increasing age?

Answer 15

Acute - increases with age

Chronic - decreases with age

Question 16

Which antigen signifies a patient is both infected and infectious?

Answer 16

HBsAg+

Question 17

Which timeframe signifies chronic hepatitis infection?

Answer 17

6 months

Question 18

An IgM test is of what use when it is known the patient has hepatitis?

Answer 18

It can aid in the differentiation between acute and chronic infection

Question 19

What does anti-HBe signify?

Answer 19

There is low infectivity

Question 20

Why do Canada, Alaska and Greenland have unusually high prevalence of hep B for being developed countries?

Answer 20

They have high indigeous populations

Question 21

In hep B, what does the presence of IgM confer about the length of time a patient has had the infection?

Answer 21

It is more commonly presented in recently infected individuals

Question 22

Which antibody is present when an individua has immunity against hep B?

Answer 22

Anti-HBs

Question 23

Which antigen is present in the blood of all infectious individuals with hep B?

Answer 23

HBsAg

Question 24

As well as HBsAG, which antigen is present in patients who are very infectious?

Answer 24

Hepatitis B e antigen (HBeAg)

Question 25

Highly infectious individuals can have which three signs present in there blood test?

Answer 25

1. HBsAg 2. HBeAg 3. High hep B viral DNA load

Question 26

Of the two, which is there a vaccine for, hep B or hep C?

Answer 26

Hep B

Question 27

Which is the most common cause of acute viral hepatitis?

Answer 27

Hep E

Question 28

Why does hepatitis B infection often lead to hepatocellular carcinoma?

Answer 28

Chronic infection leads to chronic hepatitis which will eventually progress to cirrhosis making the liver much more susceptible to cancer

Question 29

Is a spontaneous cure seen in hepatitis C?

Answer 29

No | (but it is seen in hep B)

Question 30

What is not given in the management of acute viral hepatitis?

Answer 30

Antivirals

Question 31

How is chronic viral hepatitis treated?

Answer 31

Antivirals Vaccination (against other hep viruses), influenza and pneumococcal (if cirrhotic) Decreased alcohol intake

Question 32

Which parents are treated as priority when there are many patients with hepatitis?

Answer 32

Those with cirrhosis

Question 33

What is interferon alfa?

Answer 33

Part of the immune response to viral infection It is given as injection therapy after being pegylated Used with ribavirin to treat hepatitis C

Question 34

What are the side effects of interferon alfa?

Answer 34

Flu like symptoms Thyroid disease Autoimmune disease (SLE) Psychiatric disease

Question 35

What is a side effect of ribavirin, an antiviral?

Answer 35

Haemolytic anaemia

Question 36

How can chronic hepatitis B be treated?

Answer 36

Peginterferon or Suppressive antiviral drug such as entecavir, tenofovir

Question 37

What is a sustained virologcal response (SVR) to hep C?

Answer 37

Loss of HCV RNA in blood sustained to 6 months after the end of therapy

Question 38

What is the major problem with newer antiviral aiming to replace peginterfero and ribavirin?

Answer 38

They are very expensive

Question 39

Once chronic infection is established, which type of hepatitis will not see a spontaneous cure?

Answer 39

Hepatitis C

Question 40

There is a vaccine for hepatitis C True or false?

Answer 40

False There is no vaccine for hepatitis C