Hepatitis Flashcards
WHat are LFTs in acute hepatitis?
Raised AST, ALT (GGT and ALP) and Billi
What are symptoms of acute hepatitis?
Can be asymptomatic Jaundice Tender hepatomegaly Malaise GI upset Pain
What are causes of acute hepatitis?
Viral- A, B, EBV Drugs Alcohol Vascular Obstruction Congestions
What are signs of chronic liver disease?
Clubbing Dupuytren's Spider naeivi Palmar erythema LFTs normal
What is compensated chronic hepatitis?
Liver function maintained and LFTs normal
What is decompensated chronic hepatits signs?
Ascites Jaundice Low Alb Coagulopathy Encephalopathy Varices Oedema Itching Easy Bruising Anorexia
What are complications of chornic hepatits?
HCC
Portal hypertension
Varices and bleeding
What are causes of chronic hepatitis?
Viral- B (+/-D), C Alcohol Drugs Autoimmune (PSC, PBC) Metabolic (Haemachromatosis, Wilson's, A1antitrypsin)
What investigation do you need to do in chronic liver disease?
Viral serology for hep B and C
Immunology- autoabs: AMA, ANA, Coeliac, Igs
Biochem: Iron, copper, caeuruloplasmin, 24hr urine Cu, alpha 1 antitrypsin, lipids, glucose
USS, CT
MRI
What is the commonest Hepatitis?
A
How is Hepatitis A spread?
Faeco oral
How is Hep A treated?
Self limiting 3-6 weeks
SUpportive care
Monitor LFTs to check for fulminant hepatitis
How do you get immunity to hep A
100% after infection
What is incubation period for Hep A?
2-3 weeks
How do you manage close contacts with Hep A?
HNIG Human normal immunoglobulin
NOTIFIABLE
Describe Hep E
RNA
Self limiting but chronic in immunocompromised
Faeco oral spread
How is chronic hep E deteched?
HEV RNA
What kind of virus is Hep B?
DNA Virus
How long is the hep B incubation period?
6 months
How infectiuos is hep B/
VERY
How is Hep B spread?
Needlestick
Tattoos
Sexual
Vertical
How does Hep B present?
May be aysymptomatic esp for first 5 years
How many adults clear infection?
> 90%
How many children under 5 clear infection?
100%
What are the antibody/antigen markers in Hep B?
HBcAb- Hepatitis Core antibody
HBsAB- Hepatitis surface antibody
HBsAg- Hepatitis Surface antigen
HBeAg/Ab- Hepatitis
What is serology of patients who have just been vacinated against Hep B?
Positiive HBsAb ONLY
What is serology of patients who have had previous hep B?
Positive HBcAb and HBsAb ONLY
What is the serology of patients who have chronic Hepatitis B?
Positive HBcAb and HBsAg
Pos or Neg HBaAg/Ab
What is the hepatitis B vaccine?
Inactivated HBsAg
What is PEP given in Hep B?
HBV Ig
How is Hep B treated?
Alpha interferon (6-12 months with adverse effects) OR Tenofivir/Entecavir (daily tablet) with minimal adverse effect that reduces it to undetectable with no inflammation. Must take life long, Not a cure
What is the pneumonic for remembering Hepatitis?
A is Acquired from Anus, Always cleared Acutely and only Appears once
E you get ing England and can be Eaten
B is Blood borne and if not Beaten is Bad
B and D is Dastardly
C is usually Chronic but can be Cured at a Cost
Which hepatitis coninfects with D?
B
What is caused by infection with B and D?
Fulminant hepatitis and progressive liver disease
