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w209 alcoholic liver cirrohsis > hepatitis > Flashcards

hepatitis Flashcards

1
Q

what are the pathological features of Hepatitis?

A

Liver cell necrosis and cell inflammation

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2
Q

What is the prognosis for acute hepatitis?

A

Normally self limiting with a return to normal structure and function.

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3
Q

What are the clinical presentations of Hepatitis?

A
  • Jaudice
  • Enlarged and tender liver
  • Laboratory evidence of hepatocellular damage
  • Raised serum aminotransferase lvls
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4
Q

What is the definition of chronic hepatitis?

A

> 6 months duration

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5
Q

What are the viral causes of chronic hepatitis?

A
  • Hepatitis B +/- D

* Hepatitis C

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6
Q

Name 4 drugs that can cause Chronic Hepatitis?

A
  • Methyldopa
  • Nitrofurantoin
  • Isoniazid
  • Ketoconazole
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7
Q

Name a hereditary cause of chronic hepatitis?

A

Wilson’s disease

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8
Q

What is the most common cause of chronic hepatitis in the UK.

A

Alcohol

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9
Q

what is a condition of the Gut associated with chronic hepatitis?

A

Inflammatory bowel disease

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10
Q

What is the transmission route of Hep A (HAV)?

A
  • Faecal/oral

* saliva

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11
Q

What is the transmission route of Hep B (HBV)?

A
  • Blood/Blood product
  • sexual
  • Vertical
  • Saliva
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12
Q

What is the transmission route of Hep C (HCV)?

A

•Blood/ Blood products

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13
Q

What is the transmission route of Hep D (HDV)?

A
  • Blood/blood products

* Saliva

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14
Q

What is the transmission route of Hep E (HEV)?

A

• Faecal/oral

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15
Q

What is the incubation period for Hep A?

A

2-6 weeks

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16
Q

What is the incubation period for Hep B?

A

1-5 months

17
Q

What is the incubation period for Hep C?

A

2-6 months

18
Q

What is the incubation period for Hep D?

A

1-3 months

19
Q

What is the incubation period for Hep E?

A

3-8 weeks

20
Q

Which Hepatitis viruses cause Chronic liver disease?

A
  • Hep B +/- D

* Hep C

21
Q

Which hepatitis viruses cause Liver cancer?

A
  • Hep B
  • Hep C
  • Hep D (rare)
22
Q

When is Hep E really dangerous?

A

in pregnant women ( mortality 10 -20%)

23
Q

What are the symptoms for Hep A?

A
  • Initially Fever, Malaise, Anorexia, Nausea, Arthralgia

* Followed by Jaundice (rare in children), Hepatosplenomegaly, adenopathy

24
Q

What are the symptoms for Hep B?

A
  • Initially Fever, Malaise, Anorexia, Nausea, Arthralgia + Uticaria
  • Followed by Jaundice (rare in children), Hepatosplenomegaly, adenopathy
25
Q

What is a good indicator that an individual might have Hep A?

A
  • Seafood (faecal/oral route)

* incubation period of 2-6 weeks

26
Q

What is a good indicator that an individual might have Hep B?

A
  • Recent foreign travel to an endemic area

* Incubation period of 1-5 months

27
Q

What is a good indicator that an individual might have Hep C?

A
  • Young intravenous drug user

* Chronic infection

28
Q

What are the tests for Hep B?

A
  • The first and most important test is HBsAg ( Hep B surface antigen). this is the first serum marker seen in acute infection.
  • HBeAg Appears during the first 1 1/2 - 3 months and can also be used as an acute marker of infection.
  • HBcAg (Hep B core antibody) is initially IgM and if detected indicates Acute infection.
  • HBcAg IgG replaces Igm. If this is detected without a HBsAg then it indicates the individual fought off a past infection
  • Anti-bodies to Hep B surface antigen alone imply vaccination
29
Q

What are the tests for Hep C?

A
  • Anti-HCV Antibodies confirm exposure.
  • HCV-PCR confirms on going infection/chronicity
  • Liver biopsy if HCV-PCR +ve to assess Liver damage and need for treatment
30
Q

What is a good indicator that an individual might have Hep E?

A
  • Middle aged patient

* Chronic infection - Jaundice, malaise

31
Q

What is the treatment for Hep B?

A

The aim is to clear Hep B and avoid cirhoss, HCC.

  • Old method is to Treat with Pegelated interferon.
  • Lamivudine
  • entecavir
  • Adefovir
  • tenofovir
32
Q

What is interesting about chronic infections of Hep B?

A

They will have been contracted as a baby (Vertical, blood products/saliva) and will have an incredibly high HBsAg

33
Q

What is the treatment for Hep C?

A
  • Genotype 1 → DAAs
  • sofosbuvir + ledipasvir +/- ribavirin
  • paretaprevir/r + ombitasvir + dasabuvir +/- ribavirin
  • Genotype 3 → Encouraging results with newer agents

w209 alcoholic liver cirrohsis (3 decks)

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