Hepatitis

Question 1

What are the main functions of the liver?

Answer 1

Exocrine: Synthesis & secretion of bile salts
Endocrine: Hormone secretion e.g. IGF-1, TPO
Clotting functions
Metabolism
Cholesterol metabolism
Excretory and degradative functions

Question 2

How many genotypes of Hepatitis C are there?

Answer 2

11.

1-3 have worldwide distribution and are the most common

Question 3

What does genotype 1 of Hepatitis C mean?

Answer 3

Poor response to interferon alone

Question 4

What do genotypes 2 and 3 of Hepatitis C mean?

Answer 4

More favourable responses to treatment

Question 5

What is the gold standard for treatment of Hepatitis C?

Answer 5

Pegylated Interferon-a in combination with Ribavirin

Question 6

What is the incubation period of Hepatitis C?

Answer 6

2 weeks to 6 months

Question 7

What are the symptoms of acute hepatitis c?

Answer 7

few symptoms.

Mostly fever, fatigue, nausea/vomiting etc (similar to flu)
Grey coloured skin and jaundice possible

Question 8

What is the main symptom of chronic hepatitis c?

Answer 8

Cirrhosis!

Liver cancer in 1-5%

Question 9

What is the mechanism of infection of hepatitis c?

Answer 9

Binds to CD81 and CLDN1 bind to the envelope proteins on the virus
Internalisation occurs via endocytosis (mediated by clathrin)
The low pH environment is a trigger for the release of the viral particle

Question 10

Which drugs are protease inhibitors?

Answer 10

Telaprevir and Boceprevir

Question 11

How does Telaprevir work?

Answer 11

Inhibits NS3.NS4A Serine protease complex

Question 12

How does Boceprevir work?

Answer 12

It binds the NS3 active site and inhibits

Question 13

Nucleoside RNA replicase inhibitors interact with…

Answer 13

the Catalytic site

Question 14

Non-Nucleoside RNA replicase inhibitors interact with…

Answer 14

a number of allosteric sites

Question 15

What is Sofosbuvir?

Answer 15

a nucleoside RNA replicase inhibitor

Question 16

What is ABT-333

Answer 16

a non-nuceoside RNA replicase inhibitor

Question 17

How is hepatitis C contracted?

Answer 17

Blood borne virus

Question 18

How is hepatitis A contracted?

Answer 18

Ingestion of contaminated food and water

Or direct contact with an infected person

Question 19

What are the symptoms of hepatitis A?

Answer 19

Can cause mild to severe illness

Question 20

What are the symptoms of hepatitis B?

Answer 20

attacks the liver and can cause both acute and chronic disease

Question 21

How is hepatitis B contracted?

Answer 21

through contact with the blood or other body fluids of an infected person

Question 22

What are the symptoms of hepatitis E?

Answer 22

Mild to moderate disease

Question 23

How is hepatitis E contracted?

Answer 23

Water-borne virus

Transmitted from person-to-person via the faecal-oral route

Question 24

Alcoholic hepatitis is characterised by the build up of…

Answer 24

Build up of NADH

• it inhibits gluconeogenesis
• build up of lactate (lactic acidosis and hypoglycemia)

Build up of fatty acids (‘Fatty Liver’

Question 25

What does cirrhosis lead to the build up of?

Answer 25

Ammonia

- unable to convert ammonia into urea