Hepatitis Flashcards
What are 5 non-viral causes of hepatitis?
- Alcoholic hepatitis
- Non-alcoholic steatohepatitis
- Autoimmune hepatitis
- Drug induced hepatitis
- Bacterial hepatitis
Give 8 general symptoms of hepatitis:
- Abdominal pain
- Jaundice
- Flu-like symptoms
- Nausea and vomiting
- Pruritis
- Fatigue
- Muscle and joint aches
- Light stool and dark urine
What is acute hepatitis?
Inflammation of the liver leading to cell injury and necrosis lasting<6 months
Describe the LFT results that would constitute as a ‘hepatitis picture’: (4)
1) very high alanine transaminase
2) very high aspartate transaminase
3) high alkaline phosphate (proportionally less of a rise in this)
4) raised bilirubin
What is the most common viral hepatitis worldwide?
Hep A
Is hepatitis A a DNA or RNA virus?
RNA
Is hepatitis B a DNA or RNA virus?
DNA
Are hep C,D and E RNA viruses or DNA?
RNA
How is Hep A transmitted?
Faecal oral route (Usually contaminated water)
What is a common gall bladder manifestation of hepatitis A?
Cholestasis (slow moving of bile flow through biliary system)
How long is the incubation period for Hep A?
2-6 weeks
What are the clinical features of Hep A?
- Fever
- Malaise
- Anorexia
- Nausea
- Arthralgia (joint pain)
Then Jaundice (rare in children), hepatosplenomegaly, and adenopathy
Mostly in children, they are asymptomatic
What are the test results expected in those with Hep A?
AST and ALT rise 22-40d after exposure (ALT may be >1000IU/L), returning to normal over 5-20wks.
*IgM rises from day 25 and means recent infection.
*IgG is detectable for life
How is hepatitis A diagnosed?
IgM antibody serology (raised)
What is the treatment for Hep A?
- Supportive
- Avoid alcohol
- Rarely, interferon alfa for fulminant hep
What vaccinations can you receive for Hep A?
Active immunisation with inactivated viral protein
1 IM dose gives immunity for 1yr (20yrs if further boost is given at 6-12 months)
What is the prognosis for Hep A?
- Typically, self-limited acute hepatitis
- May rarely lead to fulminant hepatic failure and subsequent death
Can relapse (rarely), but never becomes chronic
What is fulminant hepatitis?
liver failure with massive liver necrosis
Can hep A be sexually transmitted?
Yes
What are the complications of Hep A?
- Extra-hepatic complications are very rare, but include arthritis, myocarditis and renal failure.
- Acute fulminant liver failure (0.1-0.4%)
- Some patients may feel ill for months after the disease - Post hepatitis syndrome
How is hepatitis B transmitted?
1) blood (sharing needles, sharing razors, direct contact with open cuts)
2) bodily fluids (sexual intercourse)
3) vertical transmission
How long does it typically take to recover from hepatitis B?
1-3 months
What does it mean to be a hepatitis B carrier?
the viral DNA has integrated into the cell nucleus allowing cells to continue to produce viral proteins
What is the epidemiology of Hep B?
Extremely high transmission rate.
Deaths:1 million/yr.
Endemic in: Far East, Africa, Mediterranean