Hepatitis Flashcards
What is the first test performed in the diagnosis of Hepatitis?
Hep Bs Ag
postive surface antigen shows active disease acute/chronic
What does a high viral load mean?
Patient is highly infective
What does a positive Hep Bs Ab mean?
The patient has either recovered from an acute infection or has been immunised
How can you tell the difference between someone who has been immunised and a recovered hepatitis patient?
Those who have recovered will had the Hep B core Ab whereas those who have been immunised will not
How is Hep A spread?
Faecal-Oral
A for Arse
What are the risk factors for Hep A?
Poor hygeine
Over crowding
Gay men
IV drug users
Is Hep A acute or chronic?
Acute
How do you diagnose Hep A?
Clotted blood for serology
(Gold top vacutainer)
Look for Hep A IgM
How do you control Hep A?
Improve hygiene and provide prophylactic vaccination
Where is Hep E most common?
The tropics
How does Hep E present clinically?
Like hep A
How is Hep E spread?
Faecal-Oral
When do you find Hep D?
In patients with Hep B
How is Hep B spread?
Mother to child
Blood
Sex
What are the risk factors for Hep B?
Multiple sexual partners
IV drug users
Children of infected mothers
How can you control Hep B?
Safe blood Safe sex Prevent needle exchange Screen pregnant women Vaccination Prophylaxis
Is C acute or chronic?
Chronic
How is hep C spread?
The same as Hep B
What is the management for Acute Viral Hepatitis?
Manage symptoms
Monitor for encephalopathy and further infections
Notify public health
Trace contacts
What is the management of chronic viral hepatitis?
Antivirals
Vaccinations for other hepatitides
Reduce alcohol intake
Screen for cancer
When is antiviral treatment used in the treatment of hepatitis?
Patients who: Chronic infection At risk of complications Without contraindications (cancer) Have correct attitude
You must treat before complications and when there is evidence of inflammation
What are the main antivirals used in hepatitis and what are their side effects?
Peginterferon - Flu like symptoms
Ribavirin - anaemia
Telaprevir and Boceprevir - Rash and anaemia
What is peginterferon?
A long acting interferon that is normally produced by the body in response to viral infections
What is the clinical presentation of autoimmune hepatitis?
Hepatomegaly Jaundice Splenomegaly Elevated AST and ALT Elevated PT General symptoms like Malaise, fatique, anorexia, abdominal pain
