Hepatitis Flashcards
What is hepatitis
inflammation of the liver
Difference between acute and chronic
acute- less than 6 months of onset
chronic- more than 6 months
presentation of acute hepatitis
general malaise
myalgia
gi upset
abdo pain
with or without cholestatic jaundice
causes of acute hepatitis
Infective
Viral = Hep A , Hep E , EBV
Non - viral
- leptospirosis
Chronic hepatitis presents as
- +/- signs of chronic liver disease:
- Clubbing
- Palmar erythema
- Dupuytren’s contracture (one or more fingers bending into palm of hand)
- Spider naevi
- LFTs e.g. AST and ALT can be normal
- Compensated liver function can be maintained with cirrhosis
Define Hep A
The Hepatitis A virus is a non-enveloped single-stranded RNA virus.
How does Hep a spread
- faeco - oral route
- uncommon in uk
- common in africa and south america
Is hep a acute or chronic
acute only
What do adults experience with Hep A
- ## mild self - limiting manifesting with flu like symptoms
risk factors of Hep a
travel
sexually risky
haematological disorders
iv drug user
Pathophysiology of hep a
- picornavirus
- Replicates in the liver, is excreted in bile and then excreted in the faeces for about 2 weeks before the onset of clinical illness and for up to 7 days after
when is hep a most infectious
just before onset of jaundice
is there immunity after infection with hep a
yes 100%
describe the phases of Hep a
- Incubation:**Hepatitis A has a relatively long incubation period that may last from 2 - 6 weeks (mean 28-30 days).
- Prodromal: Early part of the disease, characterised by fever, joint pain and rash. Flu-like symptoms may be present
- Icteric:**In addition to jaundice, the icteric phase is characterised by anorexia, abdominal pain and change in bowel habit.
- Convalescent:**Recovery phase as the body returns to normal and symptoms subside. Symptoms like malaise may last months.
key presentation of hep a
mild illness with flu like symptoms and gi upset
hep a signs
- Jaundice
- RUQ tenderness
- Hepatomegaly (85%)
- Splenomegaly (15%)
- Lymphadenopathy (5%)
symptoms in hep a
- Abdominal discomfort
- Nausea
- Arthralgia
- Anorexia
- Diarrhoea
- Flu-like illness
- Pruritus
- Dark urine, pale stool
- Rash
1st line investigation in hep a
- serology , HAV- igM positive soon after symptoms
Management of Hep a
- supportive
- oral hydration
- nausea- metoclopramide
Define Hep b
It is an enveloped DNA virus that belongs to the Hepadnaviridae family and can cause acute or chronic hepatitis:
HBV genotype
- It is a DNA virus that contains a nucleocapsid and outer envelope.
- Its small DNA genome is contained within the nucleocapsid.