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Laura's GI Pathology > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

How is Hepatitis A spread?

A

Faecal-oral spread

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2
Q

How does Hep A harm the liver?

A

Directly cytopathic - kills hepatocytes by being in them

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3
Q

Is it possible to have a carrier state for Hep A?

A

No

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4
Q

What are the symptoms of Hep A?

A

jaundice
pale stools
dark urine

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5
Q

How is Hep A confirmed in the lab?

A

Clotted blood for serology

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6
Q

How is Hep A controlled?

A

Hygiene

Vaccine prophylaxis - travellers, MSM, IVDU

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7
Q

Pt presents with abnormal LFTs with high ALT/AST, should viral hep be considered a DD?

A

Yes

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8
Q

What are the general symptoms of viral hepatitis?

A 
headache
myalgia 
arthralgia
nausea
anorexia 
jaundice follows a few days to 2 weeks later with N&V and abdo discomfort
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9
Q

Where in the world is hep E most common?

A

Tropics

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10
Q

Is Hep A more common than Hep E in the UK?

A

No Hep E is more common

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11
Q

How is Hepatitis E spread?

A

Faecal-oral spread

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12
Q

Cases in the UK of Hep E are thought to be what?

A

Zoonoses

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13
Q

Is there a vaccine available for Hep E?

A

No

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14
Q

Hep D is only found with which other Hepatitis?

A

Hep B - parasitizes off this and exacerbates the Hep B infection

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15
Q

What are the modes of transmission of Hep B?

A

Sex - Intercourse
Mother to child - Infant
Blood to blood - Inoculation

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16
Q

What groups of people in the UK are at higher than average risk of Hep B infection?

A

Ethnic minorities
Multiple sexual partners
IVDU, tattoos, needle-stick injuries
Children of infected mothers

17
Q

What blood tests are required for the diganosis of Hep B? At what time intervals are they required?

A

2 blood tests 6 months apart for HBsAg

18
Q

Hep B IgM is most likely to be present in…

A

recently infected cases

19
Q

HBsAg is present in…

A

blood of all infectious individuals

20
Q

How is the spread of Hep B controlled?

A

Safe blood
safe sex
needle exchange programme
screening of pregnant women

21
Q

How does Hepatitis B harm the liver?

A

antiviral immune response

22
Q

After initial infection with Hep B, how do patients present?

A

asymptomatically
nausea for a period of days or weeks
may become very ill very quickly (fulminant hepatitis)

23
Q

What is the mode(s) of transmission of Hep C?

A

sex
infant
blood- blood

24
Q

Does Hep C result in chronic infection?

A

Yes, in about 75% of cases

25
Q

What symptoms are caused by Hep C?

A

Most pts are asymptomatic - slip into the phase of chronic infection easily

26
Q

How are Hep B and Hep C differentiated?

A

Serology

27
Q

Is a spontaneous cure seen in Hep C?

A

No

28
Q

Is a spontaneous cure seen in Hep B?

A

Not uncommon, even after many years of infection

29
Q

How long does it take for chronic hepatitis to develop into cirrhosis?

A

typically >20 years

30
Q

How long does it take for chronic hepatitis to develop into hepatocellular carcinoma?

A

typically >30 years

31
Q

Histologically, how is Hep C described?

A

councilman bodies with small amounts of steatosis (fat infiltration of hepatocytes) present

32
Q

Is autoimmune Hep more common in males or females?

A

Females

33
Q

What autoantibodies are seen in autoimmune hepatitis?

A

autoantibodies to smooth muscle, nuclear or LKM

there is also raised IgG

34
Q

Histologically, how is autoimmune hep described?

A

chronic hepatitis with marked piecemeal necrosis and lobular involvement. Numerous plasma cells.

35
Q

What is the treatment for autoimmune hepatitis?

A

Prednisolone and azathioprine (long term)

36
Q

What is the treatment for chronic hep B?

A

peginterferon alone
or
supressive antiviral drug (e.g. entecavir, tenofovir)

37
Q

What is the pharmacological management for chronic hep C?

A

Peginterferon injections given in combination with ribavirin tablets (PR)
12-48 week course

Laura's GI Pathology (13 decks)

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