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Gastroenterology > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

How are the types of viral hepatitis transmitted?

A

A - Faecal-oral
B - blood/bodily fluids
C - blood
D - with hepatitis B
E - faecal-oral route

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2
Q

What are the other causes of hepatitis?

A

Alcoholic hepatitis
Non-alcoholic hepatitis
Autoimmune hepatitis
Drug induced hepatitis

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3
Q

What are the clinical features of acute viral hepatitis?

A

Flu-like symptoms
Jaundice
Anorexia
Nausea and vomiting
Abdominal pain

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4
Q

What are the clinical signs of acute viral hepatitis?

A

Fever
Hepatomegaly
Splenomegaly
Ascites

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5
Q

What LFT results would be seen in viral hepatitis?

A

High ALT and AST
Raised ALP (but proportionally less of a rise compared to AST and ALT)
Raised transaminases
Raised bilirubin

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6
Q

What investigation is diagnostic of acute viral hepatitis A?

A

IgM antibodies to hepatitis A

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7
Q

What is the management of hepatitis A?

A

Supportive management
- IV fluids
- Analgesia
Vaccination

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8
Q

What are the complications of hepatitis A?

A

Fulminant hepatitis
Relapsing hepatitis

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9
Q

What are the risk factors for hepatitis B?

A

Unprotected sex
Sharing needles
Healthcare work

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10
Q

What does hepatitis B surface antigen (HBsAg) indicate?

A

Indicates current infection
- If it has been present for more than 6 months - suggests chronic infection

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11
Q

What does hepatitis B e antigen (HBeAg) indicate?

A

Indicates high viral load
Predictive of progression to chronic hepatitis

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12
Q

What do antibodies to hepatitis B core antigen (anti-HBc) indicate?

A

Indicated current or previous hepatitis B infection
- IgM - infection within last 6 months
- IgG - infection more than 6 months ago

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13
Q

What do antibodies to hepatitis B surface antigen (anti-HBs) indicate?

A

Indicates immunity to hepatitis B (may be due to vaccination or previous infection)

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14
Q

What is the management of hepatitis B?

A

Supportive management (IV fluids, analgesia)
Vaccination
Anti-virals - tenofovir or entecavir
Pegylated interferon

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15
Q

What are the complications of chronic hepatitis B?

A

Chronic liver disease
Liver cirrhosis
Hepatocellular carcinoma

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16
Q

What are the risk factors for hepatitis C?

A

Sharing needles
Healthcare work
Unprotected sex (less common than hepatitis B)

17
Q

What investigations are used to diagnose hepatitis C?

A

Hepatitis C antibody - screening
Hepatitis C RNA testing - diagnostic

18
Q

What is the management of hepatitis C?

A

Antivirals (8 to 12 weeks)
- Telaprevir plus ribavarin
- Sofosbuvir plus ribavirin
- Simeprevir plus ribavarin

19
Q

What are the complications of hepatitis C?

A

Chronic hepatitis
Cirrhosis
Hepatocellular carcinoma

20
Q

What investigations are used in the diagnosis of hepatitis E?

A

LFTs - elevated ALT/AST, bilirubin, ALP and gamma-GT
Hepatitis E IgM antibodies
Viral PCR

21
Q

What is the management of hepatitis E?

A

Supportive management
- IV fluids
- Analgesia

22
Q

What antibodies are associated with autoimmune hepatitis?

A

ANA
Anti-smooth muscle antibody (ASMA)
Anti-SLA/LP (anti-soluble liver antigen/liver-pancrease antibody)
Anti-LC1 (anti-liver cytosol 1 antibody)

23
Q

What are the types of autoimmune hepatitis?

A

Type 1 - typically affects women in 40s/50s, presents after menopause and is less acute.

Type 2 - usually affects young people, more commonly girls. Presents with acute hepatitis/

24
Q

What antibodies are associated with type 1 AIH?

A

ANA
ASMA
Anti-SLA/LP

25
Q

What antibodies are associated with type 2 AIH?

A

Anti-LKM1
Anti-LC1

26
Q

What HLA genotypes are associated with type 1 AIH?

A

DR3 and DR4

27
Q

What HLA genotypes are associated with type 2 AIH?

A

DQB1 and DRB1

28
Q

What are the symptoms of autoimmune hepatitis?

A

Fatigue
Arthralgia
Weight loss
Nausea
Amenhorrhoea

29
Q

What are the clinical signs of autoimmune hepatitis?

A

Jaundice
Gynaecomastia
Splenomegaly
Ascites
Variceal bleed
Encephalopathy
Spider telangiectasia

30
Q

What investigations are used to diagnose autoimmune hepatitis?

A

LFTs
- Raised ALT and AST
- Minimal change in ALP
Raised IgG
Liver biopsy - interface hepatitis seen
Viral screen - exclude viral hepatitis
Autoimmune screen

31
Q

What is the management of autoimmune hepatitis?

A

First line - prednisolone and azathioprine
Hepatitis A and B vaccines
Second line - transplantation

32
Q

What are the complications of autoimmune hepatitis?

A

Cirrhosis
Osteoporosis
Cushing’s syndrome
Hepatocellular carcinoma

Gastroenterology (23 decks)

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