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infection > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

How is Hep A transmitted

A

Faecal-oral

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2
Q

What is the incubation of Hep A

A

28 days

Most infective a week before symptoms appear till a few days after

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3
Q

What are the symptoms of Hep A

A 
Mild 
Fever
Malaise
Anorexia
N+V
Abdominal pain
Jaundice
Dark urine / pale stools
HSM
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4
Q

Who is at risk of Hep A

A 
MSM 
PWID
Sewage workers
Haemophiliacs 
Travel
Chronic liver disease
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5
Q

How do you diagnose Hep A

A

IgM Anti-HAV
IgG reflects past exposure + immunity
Elevated liver enzymes

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6
Q

What is the Rx of Hep A

A

No specific treatment
Human Ig prophylaxis
Vaccine (active if high risk)

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7
Q

Complications of Hep A

A

No chronic damage

Prolonged fatigue / jaundice

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8
Q

How is Hep B transmitted

A

Vertical - babies

Horizontal - blood / sexual / body fluids

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9
Q

Who is high risk of Hep B and advised active immunisation?

A 
PWID
MSM
Multiple partners
Immigration 
Haemodialysis / haemophiliac
Babies with risk mother
Close contacts
Health care personal 
Tattoos / piercings
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10
Q

Explain hepatitis B virus virology?

A

HbsAg = surface antigen
HBcAg = core antigen which secretes E antigen detected in blood
Viral DNA

E antigen and viral DNA = highly infectious

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11
Q

What is the incubation of Hep B

A

Weeks - 6 months

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12
Q

What are the symptoms of Hep B

A 
Fever
Lethargy
Anorexia
N+V
Abdominal pain
Arthralgia 
Skin lesion 
Dark urine
Jaundice
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13
Q

What is the risk of chronic infection with Hep B?

A

Neonates = 90% chronic
In adults = 90% recovery

Fulminant Hepatic Necrosis <1%

  • DIC
  • Encephalpathy
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14
Q

What is chronic Hep B

A

Presence of HBsAg > 6 months

More likely if immunocompromised

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15
Q

Complications of chronic Hep B

A 
Cirrhosis 
Hepatoma
Membranous GN
Polyarteritis Nodosa 
Cryroglobulinaemia 
Vasculitis rash
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16
Q

EPP restrictions with Hep B

A

Can’t perform if
HBeAg / HBsAg +ve
Viral DNA >1000
Hep C

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17
Q

How do you diagnose Hep B

A

Increased liver enzymes

Anti HbC IgM + IgG

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18
Q

How do you treat Hep B

A

Anti-viral if

  • cirrhosis
  • HBV >2000
  • increased ALT
  • significant inflammation

Hb IG
Pegylated interferon
Liver transplant

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19
Q

Prophylactic Rx of Hep B

A

Active immunisation (vaccine) given to babies
HBIG if no response to vaccine
HBIG and vaccine for PEP
Given if on chemo as risk of reactivation and family and sexual contacts

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20
Q

How is Hep C transmitted

A

Blood borne

Very low risk of sexual

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21
Q

RF for hep C transmission

A

PWID
HAemophiliac
Blood products / transfusion / dialysis
Tattoo / piercing

22
Q

Symptoms of Hep C

A 
Mild 
Malaise
Anorexia
Fatique 
Jaundice
23
Q

Risk of chronic infection with hep C

A

Develops in most

24
Q

Complications of Chronic

A

Cirrhosis
Hepatoma
Can be asymptomatic for years

25
Q

What accelerates Hep C

A

Alcohol

26
Q

How do you diagnose Hep C

A

Increased liver enzymes
No IgM
IgG not detected for months
HVC antigen detection

27
Q

How do you treat Hep C

A

Pegylated interferon
RIbavarin
No PEP or vaccine

28
Q

Response to Rx

A

Depends on age / gender / liver disease and amount of virus

Non responder

Viral breakthrough = respond initially

Relapser = virus returns when Rx stopped

Sustained viral response = undetectable virus

29
Q

How is Hep D transmitted

A

Parenteral - PWID
Little vertical / sexual
Need HBV

30
Q

Who is at risk of Hep D

A

PWID

31
Q

How do you diagnose Hep D

A

IgM and IgG

32
Q

Rx of Hep D

A

Pegylated interferon
Liver transplant
prevent Hep B

33
Q

What are the chronic complications of hep D

A

Chronic Hep B

Cirrhosis

34
Q

What are the symptoms of Hep D

A

More severe Hep B symptoms

35
Q

How is Hep E transmitted

A

Faecal-oral

36
Q

What is the incubation for Hep E

A

40 days

37
Q

What are the symptoms of Hep E

A 
Resembles HVA 
High mortality in pregnant women 
Increased transaminase 
Arthritis 
Anaemia
Neurological
38
Q

What are the complications of Hep E

A

Persistent infection in immunocompromised

Liver failure if chronic liver disease

39
Q

How do you diagnose Hep E

A

IgG and IgM

No specific test so under diagnosed

40
Q

How do you treat Hep E

A

Mostly self-limiting
No licensed treatment
Vaccine in China

41
Q

What infections are associated with Hepatitis

A 
Rubella 
CMV / EBV 
HSV
Enterovirus
VZV 
Yellow fever 
Leptospirosis
Q fever
Psittacosis
42
Q

Transmission of Hep B

A 
Blood borne
Needles
Sexual 
Vertical 
Horizontal
43
Q

What should a pregnant lady with Hep B have given to her baby?

A

Hep B specific antigen

Ig 1, 2, 3 and 12

44
Q

What is Hep B e a measure of?

A

Infectivity

45
Q

Is hepatitis a notifiable disease?

A

Yes

46
Q

Which hepatitis cannot be vaccinated against?

A

Hep C

47
Q

Complication of Hep C

A

Liver cirrhosis

HCC

48
Q

Which hepatitis may cause chronic disease?

A

Hep B

49
Q

What hepatitis infections cause HCC?

A

B

C

50
Q

What vaccine should be offered to patients with chronic hepatitis?

A

Pneumococcal

51
Q

How to monitor Hep C infection

A

Viral load

infection (16 decks)

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