Hepatitis

Question 1

List 4 risk factors for hepatitis C infection.

Answer 1

· Current or past injection drug users
· Individuals who have been incarcerated
· Individuals who were born, travelled, or resided in HCV-endemic countries
· Individuals who have received health care where there is a lack of universal precautions
· Recipients of blood transfusions, blood products or organ transplant before 1992 in Canada
· Patients on hemodialysis
· Individuals who have had needle-stick injuries
· Individuals who have engaged in other risks sometimes associated with HCV exposure, such as high-risk sexual behaviors, homelessness, intranasal and inhalation drug use, tattooing, body piercing or sharing sharp instruments or personal hygiene materials with someone who is HCV-positive
· Anyone with clinical clues suspicious for HCV infection (and above risk factors)

Ref: CFPC Self-Learning Vol 32.6

Question 2

List 3 major causes of cirrhosis

Answer 2

Chronic HBV
Chronic HCV
Alcoholism
Non-alcoholic steatohepatitis

Question 3

What are the risks/complications of cirrhosis. List 4.

Answer 3

Portal hypertension 
Ascites 
Spontaneous bacterial peritonitis 
Hepatic encephalopathy 
Variceal hemorrhage 
Hepatorenal syndrome
Hepatocellular carcinoma

Question 4

You diagnose HBV or HCV in a patient. What other blood borne pathogen should you test for?

Answer 4

HIV

Question 5

What is an early lab sign of advancing liver disease (besides elevated liver enzymes)?

Answer 5

Platelets less than 150

(Low plts assc. w/ bleeding varices