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Year 1 > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

How is Hepatitis A transmitted?

A

Faecal-oral spread

Risk higher in poor hygiene/overcrowding

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2
Q

How is Hepatitis E transmitted?

A

Faecal-oral spread
More common in tropics.
NO VACCINE

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3
Q

How is Hepatitis D transmitted?

A

Hepatitis D is a parasite of a parasite and is only with Hepatitis B. Hepatitis B is transmitted through blood exchange, mother to child, and sexual intercourse.

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4
Q

How is Hepatitis B transmitted?

A

Hepatitis B is transmitted through blood exchange, mother to child, and sexual intercourse.

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5
Q

How is Hepatitis C transmitted?

A

transmitted through blood exchange, mother to child, and sexual intercourse

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6
Q

How can Hep A be prevented?

A

Vaccine prophylaxis, 10 days to take effectbut gives long-term protection
Hygiene

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7
Q

How would labs confirm acute infection of Hep A?

A

Clotted blood for serology using gold top vacutainer.

Confirm with presence of Hepatitis A IgM

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8
Q

How would labs confirm infection of Hepatitis B?

A

Hepatitis B surface antigen HBsAg present in blood in all infectious individuals.
In HIGHLY infectious indivudals
Hepatitis B e antigen usually present
Hep B virus DNA ALWAYS present in infected individuals (wether asymptomatic or not)

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9
Q

Hep B DNA tests are also used to..

A

predict risk of chronic liver disease and monitor therapy

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10
Q

Serology of Hep B

A

Hep B IgM to be present in recently infected cases

Anti Hep Bs present in immunity

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11
Q

How can Hep B be controlled?

A

Minimise exposure through safe sex, screening pregnant women, needle clean, safe blood transfusions
Vaccination people at risk and children
Post-exposure vaccinate and give hyperimmune hep B immunoglobin HBIG

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12
Q

How can Hep C be controlled?

A

Minimise exposure through safe sex, screening pregnant women, needle clean, safe blood transfusions
There is NO vaccine available for Hep C!

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13
Q

Describe the natural history of Hep B virus

A

Dynamic relationship with infection in chronically infected patient. May go from immune tolerance to control to escape etc. Basically patients who are being monitored at first may need treatment later on. Spontaenous cure not uncommon, even after years of infection.
Can be asymptomatic, acute hepatitis (and resolved) or lead to acute liver failure.
If infected at birth then same pattern as Hep C.

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14
Q

Describe the natural history of Hep C virus

A

Infection results in chronic infection in most cases. Age does not seem to be a factor in changing course of infection. Once infection is established then it does not go away.
Chronic infection leads to cirrhosis or cancer, difficult to treat, leads to acute liver failure and death.

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15
Q

Describe the natural history of Hepatitis A

A

Infection could lead to acute hepatitis or can be asymptomatic, this is usually resolved.
However patient could develop acute liver failure and die. This is rare. Could develop acute liver failure from untreated acute hepatitis - risk developing cirrhosis or carcinoma.

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16
Q

How long do you have to have infection for it to be classified chronic?

A

6 months at least

17
Q

Management of acute viral hepatitis?

A

Monitor for resolution (serology) and for encephalopathy (key sign of acute liver failure)
No antivirals
Notify public health
Vaccinate if at risk

18
Q

What are the most commonly used antivirals for chronic Hep B?

A

Adefovir

Entecavir

19
Q

Management of chronic hep infection?

A

Antivirals
Vaccination against other Hepatitis viruses, if cirrhotic pneumococcal and infleunza
Infection control
Less alcohol
Carcinoma awareness/screening Alpha feto protein serum checks and ultrasounds

20
Q

When should patients be treated?

A

Before they establish complications (cancer is contraindication.)
When there is evidence of inflammation
Patients with advanced fibrosis short of cirrhosis
Patients with cirrhosis

21
Q

What is pegylated interferon?

A

It is a form of interferon alfa which is a human protein part of the immune response to viral infection.
Given by injection.
Many side effects so used less and less.

22
Q

What are the side effects of pegylated interferon?

A

Flu like - chills, malaise, sore muscles

Less common ones include psychosis, thyroid disease, autoimmune disease.

23
Q

What are the advantages of pegylated interferon?

A

Possibility of cure in some patients within few months of therapy.
More successful in patients with Hep surface antigen (HBsAg) and Hep B e Antigen.

24
Q

What are the advantages and disadvantages of using antivirals instead of peginterferon?

A

Safer with an increasing range available

Supression not cure, resistance can develop

25
Q

What is the virological definition of cure and supression with regards to hepatitis B?

A

Suppression is loss of HBV DNA
enduring suppression is loss of HB e antigen
Cure is loss of Hepatitis B Surface Antigen

Year 1 (15 decks)

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