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Liver > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

define hepatitis

A

inflammation of liver as a result of viral replication inside hepatocytes

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2
Q

on histology what would all types of hepatitis show?

A

interface necrosis

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3
Q

what must you do with all types of hepatitis?

A

report to public health

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4
Q

what is hepatitis A?

A

pircorna virus

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5
Q

in Hepatitis A: what is the virus type?

A
  • acute
  • single stranded RNA
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6
Q

in Hepatitis A: how is it spread?

A
  • Face- oral spread
  • contaminated water and food ( shellfish)
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7
Q

in Hepatitis A: what are the risk factors?

A
  • travel
  • eating shellfish
  • homelessness- overcrowding
  • living with people who have it
  • poor sanitisation
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8
Q

in Hepatitis A: what are the phases?

A
  1. incubation- 2 weeks no symptoms
  2. prodromal - pre-icteric
  3. Icteric
  4. recovery
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9
Q

in the prodromal phase ( 1-2 weeks)-what are the symptoms of Hepatitis A?

A
  • nausea and vomiting
  • fever
    -malaise
  • RUQ pain
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10
Q

in the icteric phase ( 3 months )-what are the symptoms of Hepatitis A?

A

-jaundice
-dark urine
- pale stool
-pruritus
-heapatosplenomegaly

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11
Q

how is hepatitis A diagnosed?

A
  1. bloods
  2. LFT
  3. Serology
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12
Q

what blood tests are done to diagnose HEP A?

A
  • high ESR
  • Leukopenia
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13
Q

what would LFT show in HEP A ?

A
  • high bilirubin
  • high ALT
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14
Q

what would serology show in HEP A ? (before/ after infection )

A

when under active infection - high HAV Igm antibodies
after infection - high anti HAV IgG antibodies

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15
Q

what is the treatment for HEP A?

A
  • supporting care
    -travellers vaccine
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16
Q

what are complications associated with HEP A?

A
  • fulminant liver failure- rare
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17
Q

what is HEP B?

A

Hepadna virus

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18
Q

in HEP B: what is the virus type?

A
  • double stranded DNA
  • Acute and chronic
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19
Q

in HEP B: how is it spread?

A
  • blood borne
  • bodily fluids
  • sharing needles
  • vertical/ horizontal transmission
  • dialysis
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20
Q

in HEP B: what are the symptoms in the prodromal phase ( 1-2 week)?

A
  • nausea and vomiting
  • fever
  • malaise
  • RUQ pain
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21
Q

in HEP B: what are the symptoms in the icteric phase ( few weeks- 6 months) ?

A
  • jaundice
  • dark urine
  • pale stools
    -prurritus
  • arthralgia
  • urticaria
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22
Q

in HEP B: how is it diagnosed?

A

serology

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23
Q

in HEP B: what does the serology look for?

A
  1. Hb S Ag- ( s- surface antigen)
  2. Anti Hb S Ag
  3. Hb E Ag
  4. Anti Hb E Ag
  5. HBV DNA
  6. Hb C Ag ( c- inner core antigen)
  7. anti Hb C Ag
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24
Q

in HEP B: in serology when does Hb S Ag appear?

A
  • in initial infection- 1-6 months
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25
Q

in HEP B: in serology when does anti Hb S Ag appear and what does it indicate?

A
  • indicates immunity or vaccination
  • appear 1-3 months after infection
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26
Q

in HEP B: in serology when does Hb E Ag appear?

A

infectivity and viral replication

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27
Q

in HEP B: in serology what does anti-Hb E Ag mean?

A

low activity and infectivity

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28
Q

in HEP B: in serology what does HBV DNA Show ?

A

viral load direct count

29
Q

in HEP B: in serology what does Hb c Ag mean?

A
  • not measured in practise
  • exposed to HEP B or some point
30
Q

in HEP B: in serology when does anti Hb C Ag appear?

A
  1. anti Hb C Igm- recent infection
  2. anti Hb C IgG- resolved or chronic infection
31
Q

in acute HEP B what would serology show?

A

HbsAg
Igm Anti HBC Ag

32
Q

in chronic HEP B what would serology show?

A

HbsAg
IgG anti HbAg

33
Q

in carrier HEP B what would serology show?

A

HbsAg
IgG anti HbAg

34
Q

in vaccine HEP B what would serology show?

A

anti HbsAg

35
Q

In HEP B: what is the treatment?

A

-pegylated interferon alpha 2a
– anti viral properties
- tenofovir
-transplant

36
Q

what is HEP C?

A

flavivirus

37
Q

In HEP C: what is the virus type?

A
  • single stranded RNA
  • acute and chronic
38
Q

In HEP C: How is it spread?

A
  • blood borne
  • bodily fluids
  • IVDU !!( Intravenous drug users )
39
Q

In HEP C: what are the symptoms in acute ?

A

-asymptomatic
or
- malaise
-fever
-myalgia
-arthalgia
- nausea and vomiting
- diarrhoea

40
Q

In HEP C: what are the symptoms in chronic?

A

usual chronic liver signs
hepatosplenomegaly

41
Q

in HEP C: what is done for diagnosis?

A

serology

42
Q

what would be present in serology in HEP C when you have no infection?

A
  • anti HC ab -ve
  • Hc RNA -ve
43
Q

what would be present in serology in HEP C when you have active infection?

A
  • anti HC ab -ve
  • Hc RNA +ve
44
Q

what would be present in serology in HEP C when you have resolved infection?

A
  • anti Hc Ab +ve
  • HC RNA -ve
45
Q

what would be present in serology in HEP C when you have acute infection- acute/chronic?

A

-anti Hc Ab +ve
- Hc Rna +ve

46
Q

what is the treatment for hepatitis C?

A
  1. Direct Acting Antivirals ( DAA)
  2. oral ribavirin + NSSA- I, + NSSB- I
47
Q

IN HEP D: what is the virus type?

A

-single stranded RNA
- acute and chronic

48
Q

IN HEP D: what other hep does it depend on?

A

D- can only survive in patients with hep B
- it attaches itself to HbSAg
- HEP b + Hep D- HIGH cirrhosis + HCC ( Igm HDV + Im HBV)

49
Q

IN HEP D what is the treatment, diagnosis, rf and symptoms the same as?

A

the same as hep b

50
Q

what is the most common hep?

A

HEP E

51
Q

IN HEP E: what is the virus type?

A

single stranded RNA
acute

52
Q

IN HEP E: how is it spread?

A
  • faeco-oral spread
    -contaminated water
  • drugs
    -undercooked pork
53
Q

IN HEP E: what are the symptoms?

A

usually asymptomatic and self limiting

54
Q

IN HEP E: what are the complications?

A
  • chronic disease in immunosupressed
  • fulminant liver disease
55
Q

IN HEP E: how is it diagnosed?

A

serology

56
Q

in non reactive HEP E- what is the serology?

A

anti HCV- negative
HCV RNA- negative

57
Q

in current infection HEP E- what is the serology?

A

anti HCV- positive
HCV RNA- positive

58
Q

in post infection HEP E - what is the serology?

A

anti HCV- positive
HCV RNA- negative

59
Q

what is the treatment for HEP E?

A

supportive
self limiting

60
Q

describe autoimune hepatitis

A

immune system attacks liver cells causing inflammation and damage

61
Q

what are the risk factors for auto immune hepatitis?

A
  • female
  • other autoimmune diseases
  • viral hepatitis
  • HLA DR3 or DR4
62
Q

who is more likely to get type 1 autoimmune hepatitis?

A

adult females

63
Q

who is more likely to get type 2 autoimmune hepatitis?

A

younger females

64
Q

what auto antibodies are involved in type 1 autoimmune hepatitis?

A

anti nuclear antibodies (ANA)
anti smooth muscle antibodies ( asma)
anti soluble liver ag

65
Q

what auto antibodies are involved in type 2 autoimmune hepatitis?

A

anti liver kidney microsomes 1
anti liver cytosol antigen type 1

66
Q

what are the symptoms for autoimmune hepatitis?

A
  • 25% asymptomatic
    -jaundice
    -fever
    -hepatosplenomegaly
67
Q

how is autoimmune hepatitis diagnosed?

A

serology of antibodies

68
Q

how is autoimmune hepatitis treated?

A
  • corticosteroids
    -immunosuppressants
    -transplant

Liver (21 decks)

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