Hepatitis

Question 1

What does hepatitis describe?

Answer 1

Inflammation in the liver

Question 2

What are the causes of hepatitis?

Answer 2

• viral hepatitis (A, B, C, D, E)
• alcoholic hepatitis
• non-alcoholic steatohepatitis (NASH)
• autoimmune hepatitis
• drug induced hepatitis (e.g. paracetamol overdose)

Question 3

How many types of viral hepatitis are there?

Answer 3

Five types: A, B, C, D, E

Question 4

What is the transmission method for Hepatitis A?

Answer 4

Faecal-oral

Question 5

Does Hepatitis A have a vaccine?

Answer 5

Yes

Question 6

What is the treatment for Hepatitis A?

Answer 6

Supportive

Question 7

What is the transmission method for Hepatitis B?

Answer 7

Blood/bodily fluid

Question 8

Does Hepatitis B have a vaccine?

Answer 8

Yes

Question 9

What is the treatment for Hepatitis B?

Answer 9

• Supportive
• Antivirals

Question 10

What is the transmission method for Hepatitis C?

Answer 10

Blood

Question 11

Does Hepatitis C have a vaccine?

Answer 11

No

Question 12

What is the treatment for Hepatitis C?

Answer 12

Direct-acting antivirals

Question 13

What is the transmission method for Hepatitis D?

Answer 13

Always with Hepatitis B

Question 14

Does Hepatitis D have a vaccine?

Answer 14

No

Question 15

What is the treatment for Hepatitis D?

Answer 15

Pegylated interferon alpha

Question 16

What are common clinical features of hepatitis?

Answer 16

• Asymptomatic
• Abdominal pain
• Fatigue
• Flu-like illness
• Pruritis
• Muscle and joint aches
• Nausea and vomiting
• Jaundice

Question 17

What do high transaminases (ALT, AST) indicate in liver function tests?

Answer 17

Inflammation of liver cells

Question 18

What is the most common viral hepatitis?

Answer 18

Hepatitis A

Question 19

What is the management approach for Hepatitis B?

Answer 19

• Low threshold to screen at-risk patients
• Refer to GI and hepatology
• Avoid alcohol
• Contact tracing
• Test for complications
• Antivirals
• Liver transplant

Question 20

What are the complications of untreated Hepatitis C?

Answer 20

• Liver cirrhosis
• Hepatocellular carcinoma

Question 21

What is the primary autoantibody associated with Type 1 autoimmune hepatitis?

Answer 21

• Anti-nuclear antibodies (ANA)
• Anti-smooth muscle antibodies (anti-actin)
• Anti-soluble liver antigen (anti-SLA/LP)

Question 22

What age group does Type 2 autoimmune hepatitis primarily affect?

Answer 22

Children, more common in girls

Question 23

What are common clinical features of autoimmune hepatitis?

Answer 23

• Signs of chronic liver disease
• Acute hepatitis
• Amenorrhoea

Question 24

What is the typical management for autoimmune hepatitis?

Answer 24

• High dose steroids (e.g. prednisolone)
• Other immunosuppressants (e.g. azathioprine)
• Liver transplant for end-stage disease

Question 25

What indicates interface hepatitis in liver biopsy for autoimmune hepatitis?

Answer 25

Plasma cell infiltration

Question 26

Which viral hepatitis has the worst outcomes in pregnancy?

Answer 26

Heptitis E

Presents similar to Hepatitis A - but carries 20% mortality

Question 27

Hepatitis B serology - vaccine non-responder

HBsAg
Anti-HBsAg
Anti-HBcAg IgM
Anti-HBcAg IgG

Answer 27

HBsAg (-)
Anti-HBsAg (-)
Anti-HBcAg IgM (-)
Anti-HBcAg IgG (-)

Question 28

Hepatitis B serology - vaccine responder

HBsAg
Anti-HBsAg
Anti-HBcAg IgM
Anti-HBcAg IgG

Answer 28

HBsAg (-)
Anti-HBsAg (+)
Anti-HBcAg IgM (-)
Anti-HBcAg IgG (-)

Question 29

Hepatitis B serology - acute infection

HBsAg
Anti-HBsAg
Anti-HBcAg IgM
Anti-HBcAg IgG

Answer 29

HBsAg (+)
Anti-HBsAg (-)
Anti-HBcAg IgM (+)
Anti-HBcAg IgG (+/-)

Question 30

Hepatitis B serology - chronic infection

HBsAg
Anti-HBsAg
Anti-HBcAg IgM
Anti-HBcAg IgG

Answer 30

HBsAg (+)
Anti-HBsAg (-)
Anti-HBcAg IgM (-)
Anti-HBcAg IgG (+)

Question 31

Hepatitis B serology - previous infection, now immune

HBsAg
Anti-HBsAg
Anti-HBcAg IgM
Anti-HBcAg IgG

Answer 31

HBsAg (-)
Anti-HBsAg (+)
Anti-HBcAg IgM (-)
Anti-HBcAg IgG (+)