Hepatitis

Question 1

5 hepatitis viruses

Answer 1

A, B, C, D and E

Question 2

which viruses are transferred through faecal oral route

Answer 2

A and E

Question 3

which viruses only occur acutely with no chronic phase

Answer 3

A and E

Question 4

which viruses can have chronic stages

Answer 4

B, C and D

Question 5

why don’t A and E cause chronic disease

Answer 5

because they are self-limiting infections

Question 6

death toll to viral hepatitis each year

Answer 6

1 million

Question 7

in HAV and HEV what do the immunoglobulins indicate about the infection

Answer 7

IgM = active infection
IgG = recovery or vaccination

Question 8

symptoms of hepatitis

Answer 8

fever, malaise, nausea
hepatomegaly
pain

Question 9

is there a vaccination against HEV

Answer 9

no

Question 10

is there a vaccination against HAV

Answer 10

yes - given to chronic liver disease, lab workers and gay men

Question 11

what type of people is HEV a particular concern in

Answer 11

pregnant women

Question 12

ways of acquiring infection of HBV, HCV and HDV

Answer 12

sex, drug use

Question 13

what condition is associated with HBV infection

Answer 13

hepatocellular carcinoma

Question 14

4 antigens in HBV

Answer 14

surface, e, core and DNA

Question 15

what state is the virus in if e and core and DNA antigens are detected

Answer 15

active replication

Question 16

where is DNA in a HB virus

Answer 16

in the middle, inside the inner protein core

Question 17

if someone has high levels of IgM anti-HBc what does this indicate

Answer 17

they are in acute infection

Question 18

if someone has high levels of IgG anti-HBc what does this indicate

Answer 18

chronic infection or exposure

Question 19

if someone has anti-HBsurface what does that tell you

Answer 19

they are protected

Question 20

treatment guidelines for HBV

Answer 20

antiviral drugs (end with “vir”) or peginterferon

transplant may be considered if end stage

Question 21

toxicity of tenofovir

Answer 21

renal toxicity

Question 22

LFTs in hepatitis

Answer 22

ALT>AST

low albumin or high bilirubin from cirrhosis

Question 23

treatment for HCV

Answer 23

antiviral drugs or peginterferon

transplant may be considered if end stage

Question 24

what hepatitis commonly co infects with HBV

Answer 24

HDV

Question 25

what is HBV superinfection

Answer 25

someone with HBV get HDV some time after the initial HBV infection

Question 26

where is hep E common

Answer 26

sort of equator especially asia

Question 27

what is the commonest cause of acute hepatitis in grampian

Answer 27

HEV (I know I’m surprised too)

Question 28

treatment for HEV

Answer 28

none really - just supportive care