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Popular SAQ topics > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

What type of viruses are hepatotropic viruses?

A

All RNA viruses except Hepatitis B, which is a DNA virus

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2
Q

Which types of viral hepatitis are transmitted via the faecal-oral route?

A

Hepatitis A and E

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3
Q

Which type of viral hepatitis are blood-borne?

A

Hepatitis B, C and D

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4
Q

What is the most common type of hepatitis in the UK?

A

Hepatitis A

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5
Q

How is hepatitis A transmitted and what risk factor is it associated with?

A

Faecal-oral route

Poor personal hygiene (and shellfish)

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6
Q

Where is hepatitis A endemic? What is the incubation period? In whom should it be suspected?

A

Africa, South America and India

Incubation period of 2-4 weeks

So suspect in travellers who presented with symptoms 2-4 weeks after returning home

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7
Q

Is hepatitis A acute or chronic?

A

Acute

Symptoms resolve and don’t progress to chronic disease

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8
Q

Name and describe the 2 phases of hepatitis A presentation

A

Prodromal phase; Acute, Flu-like Sx, GI symptoms (abdo pain, nausea, vomiting)

Icteric phase; Jaundice, Pruritis, Dark Urine, Hepatosplenomegaly

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9
Q

Name 2 investigations used to diagnose Hepatitis A

A

LFTs - Raised ALT/AST

IgM and IgG anti-hepatitis A

(IgM detectible after 5 days, IgG after 10 days)

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10
Q

Who should be vaccinated for Hepatitis A? (5)

A

Travelling to high risk area

Chronic liver disease

Haemophillia

Men who have sex with men

IV drug users

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11
Q

What is the most common hepatitis worldwide?

A

Hepatitis B

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12
Q

Name 3 ways Hepatitis B can be transmitted

A

Parenteral (IV drugs, needle-stick injury)

Sexual

Vertical (mother to child)

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13
Q

What happens in 95% of Hep B cases?

A

Adults experience symptoms with jaundice lasting 1-3 months, followed by spontaneous resolution

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14
Q

What happens in 5% of hepatitis B patients?

A

Develop chronic hepatitis.

Can lead to Cirrhosis and increased risk of hepatocellular carcinoma

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15
Q

How is hepatitis B diagnosed?

A

Hepatitis Serology

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16
Q

What 3 biochemical markers are used in Hepatitis B serology?

A

HbsAg (surface antigen) (Indicates Acute infection 1-6 months)

Anti-HBs (Indicates Immunity - exposure or immunisation)

Anti-HBc (Indicates infection - current or previous)

17
Q

What serology results would be seen in a patient with previous immunisation to Hepatitis B?

A

Anti-HBs Positive

Anti-HBc + HbsAg negative

18
Q

What serology results would be seen in a patient who previously had hepatitis B >6 months ago and is NOT a carrier?

A

Positive anti-HBc

Negative HBsAg

19
Q

What serology results would be seen in a patient who previously had hepatitis B ago and IS a carrier?

A

Anti-HBc positive

HBs-Ag positive

20
Q

What biochemical marker can be used to quantify viral load in a patient with hepatitis B? What are high levels associated with?

A

HBV DNA

High levels are associated with a greater risk of progression to cirrhosis and hepatocellular carcinoma.

21
Q

What medications can be offered to manage hepatitis B? (2)

A

Pegylated interferon alpha

Entecavir or Tenofovir (suppress viral replication)

22
Q

How does Hepatitis C tend to progress and manifest?

A

Progresses very slowly and manifests as chronic hepatitis (rather than acute)

23
Q

How does hepatitis C tend to present?

A

Most infections are asymptomatic.

But hepatic inflammation is present (silent chronic infection) and can lead to progressive hepatic fibrosis (cirrhosis)

24
Q

How is hepatitis C investigated? (3)

A

Anti-HCV RNA (PCR) - Confirms current infection

Anti-HCV antibodies (enzyme immunoassay) - Confirms exposure

LFTs and Biopsy - Determines extent of fibrosis

25
Q

What biochemical test results would suggest active Hepatitis C infection?

A

Positive Anti-HCV antibodies + Anti-HCV RNA

26
Q

Give 4 potential complications of chronic hepatitis C

A

Cirrhosis

Hepatocellular Carcinoma

Cryoglobulinemia (type II)

Sjogren’s syndrome (eye problems)

27
Q

How is hepatitis C managed?

A

Goal is to prevent chronic disease

Combination therapy - Sofosuvir + Peginterferon alfa + Ribavirin

28
Q

Is there a vaccine for hepatitis C?

A

No

29
Q

What does Hepatitis D require for infection?

A

Concurrent Hepatitis B infection

30
Q

What vaccine helps prevent against Hepatitis D? And why?

A

Hepatitis B vaccine

As Hep D requires Hep B (HBsAg) to replicate

31
Q

Babies born to mothers with chronic hepatitis B or who have acute hepatitis B during pregnancy should receive what?

A

Hep B vaccination + Hep B immunoglobulin

32
Q

Can Hepatitis B be transmitted via breastfeeding?

A

No. It is safe to breastfeed wit hepatitis B.

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