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Z Year3 Gastro Conditions > Hepatitis 2 > Flashcards

Hepatitis 2 Flashcards

1
Q

What are the different stages of Viral Hepatitis?

A
  1. incubation period
  2. prodromal phase
  3. Icteric phase
  4. Convalescent phase
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2
Q

What happens in the incubation period?

A
  1. Virus replicaties in hepatocytes

2. No symptoms

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3
Q

How long does the prodromal phase last?

A

3-10 days

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4
Q

What are the symptoms like in prodromal phase?

A
  • Flu like symptoms:
    1. General fatigue
    2. Malaise
    3. Joint/muscle pain
    4. Low grade fever
  • GI upset leads to RUQ pain
  • No specific signs on examination
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5
Q

How long does the icteric phase last?

A

1-3 weeks can be 12 weeks

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6
Q

What are the symptoms of the icteric phase?

A
  1. Jaundice
  2. Pale stools
  3. Dark urine if cholestasis
  4. Pruritus (~40%)
  5. Hepatomegaly (85%)
  6. RUQ pain
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7
Q

How long is the convalescent (recovery) phase?

A

Up to 6 months (“post-hepatitis syndrome”)

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8
Q

What are symptoms ofconvalescent (recovery) phase?

A
  • Malaise
  • Anorexia
  • muscle weakness
  • Hepatic tenderness
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9
Q

Is there always a recovery phase?

A

no sometimes turns chronic phase can lead to cirrhosis and this can be compensated or uncompensated (chronic hep B,C,D)

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10
Q

How common is chronic hep B?

A
  1. one in three children who get infected before age 6 will develop chronic hepatitis B
  2. all older children (those aged ≥6) and adults infected with the hepatitis B virus recover completely and do not develop chronic infection.
    3/ 5-10% of healthy adults 19 years and older who are infected will develop a chronic hepatitis B infection (that is, 90% will recover from an exposure)
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11
Q

What is a superinfection?

A

infection following a previous infection especially when caused by microorganisms that are resistant or have become resistant to the antibiotics used earlier

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12
Q

How can you tell if Hep D and Hep B is a superinfection?

A

detected by very high levels of anti-HDV in blood

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13
Q

What bloods are done in viral hep?

A
  1. FBC
  2. LFTs
  3. Prolonged PT (INR) as marker of liver damage
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14
Q

What do LFTs show in Viral Hep?

A
  1. high bilirubin C+UC
  2. Low albumin
  3. high ALT/AST
  4. High GGT
  5. High ALP
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15
Q

What imaging is done in Viral Hep?

A

US scan: for other

causes of liver impairment (e.g. malignancies)

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16
Q

What does IgM on viral serology suggest?

A

now infection

17
Q

What does IgG on viral serology suggest?

A

gone

18
Q

What would HAV-IgM +ve and HAV-IgG -ve suggest?

A

Active Hep A infection

19
Q

What would HAV-IgM -ve and HAV-IgG +ve?

A

recvoered/vaccinated

20
Q

What would HAV-IgM -ve and HAV-IgG -ve suggest?

A

not vaccinated/never have

21
Q

How can you tell if there is an acute Hep E infection?

A

HEV-IgM +ve and HEV-IgG -ve

22
Q

How can you tell if the patient is recovered from Hep E?

A

HEV-IgM -ve and HEV-IgG +ve

23
Q

What would a patient with no Hep E and never has?

A

HEV-IgM -ve and HEV-IgG -ve =

24
Q

What would active Hep D infection show?

A

HDV-IgM +ve and HDV-IgG -ve

25
Q

How would recovered Hep D infection show?

A

HDV-IgM -ve and HDV-IgG +ve

26
Q

What do you need to check with Hep D?

A

CHECK HEP B SEROLOGY

27
Q

What would Anti-HCV antibodies show?

A

prior exposure, not protective

28
Q

What would a positive HCV antibody show?

A

need a HCV RNA assay (e.g. RT-PCR which will show if active or chronic)

29
Q

How do you manage the nausea in viral Hep?

A
  1. Metoclopramide

2. Cyclizine

30
Q

How do you manage the itchiness in viral hep?

A
  • 1st line: Chlorphenamine

* On specialist advice: Ursodeoxycholic acid/colestyramine/ corticosteroids (Not much data to support these..)

31
Q

How do you minimise risk to other for viral hep?

A
  1. Avoid sharing toothbrushes/razors
  2. Avoid unprotected sexual intercourse
  3. Avoid sharing needles
32
Q

What viral Hep is there a vaccine for?

A

hep A and B

33
Q

When is HBIG used?

A

are not vaccinated prior and have been exposed to HepB then give HBIG intramuscularly ideally within 48 hours of exposure, and at the same time as the first dose of vaccine

34
Q

What is a DAA?

A

directly acting antivirals. (90% cure rate in hepatitis C)  inhibit RdRp of hepatitis C virus

35
Q

What is Hep C a RF for?

A

Hepatocellular carcinoma

36
Q

What do you screen for in Hep B and Hep C?

A
  1. Hep B: HIV and Hep C

2. Hep C: HIV and Hep B

37
Q

What are extrahepatic manifestations of Hep C?

A
  1. Cryoglobulinemia
  2. Porphyria cutenea tarda
  3. Glomerulonephritis
  4. Thyroiditis
  5. Chronic kidney disease
38
Q

What are extrahepatic manifestations of Hep B?

A
  1. Polyarteritis nodosa
  2. Glomerulonephritis
  3. Vasculitis

Z Year3 Gastro Conditions (48 decks)

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