Hepatitis

Question 1

WHat are LFTs in acute hepatitis?

Answer 1

Raised AST, ALT (GGT and ALP) and Billi

Question 2

What are symptoms of acute hepatitis?

Answer 2

Can be asymptomatic
Jaundice
Tender hepatomegaly
Malaise
GI upset
Pain

Question 3

What are causes of acute hepatitis?

Answer 3

Viral- A, B, EBV
Drugs
Alcohol
Vascular
Obstruction
Congestions

Question 4

What are signs of chronic liver disease?

Answer 4

Clubbing
Dupuytren's
Spider naeivi
Palmar erythema
LFTs normal

Question 5

What is compensated chronic hepatitis?

Answer 5

Liver function maintained and LFTs normal

Question 6

What is decompensated chronic hepatits signs?

Answer 6

Ascites
Jaundice
Low Alb
Coagulopathy
Encephalopathy
Varices
Oedema
Itching
Easy Bruising
Anorexia

Question 7

What are complications of chornic hepatits?

Answer 7

HCC
Portal hypertension
Varices and bleeding

Question 8

What are causes of chronic hepatitis?

Answer 8

Viral- B (+/-D), C
Alcohol
Drugs
Autoimmune (PSC, PBC)
Metabolic (Haemachromatosis, Wilson's, A1antitrypsin)

Question 9

What investigation do you need to do in chronic liver disease?

Answer 9

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

Question 10

What is the commonest Hepatitis?

Answer 10

A

Question 11

How is Hepatitis A spread?

Answer 11

Faeco oral

Question 12

How is Hep A treated?

Answer 12

Self limiting 3-6 weeks
SUpportive care
Monitor LFTs to check for fulminant hepatitis

Question 13

How do you get immunity to hep A

Answer 13

100% after infection

Question 14

What is incubation period for Hep A?

Answer 14

2-3 weeks

Question 15

How do you manage close contacts with Hep A?

Answer 15

HNIG Human normal immunoglobulin

NOTIFIABLE

Question 16

Describe Hep E

Answer 16

RNA
Self limiting but chronic in immunocompromised
Faeco oral spread

Question 17

How is chronic hep E deteched?

Answer 17

HEV RNA

Question 18

What kind of virus is Hep B?

Answer 18

DNA Virus

Question 19

How long is the hep B incubation period?

Answer 19

6 months

Question 20

How infectiuos is hep B/

Answer 20

VERY

Question 21

How is Hep B spread?

Answer 21

Needlestick
Tattoos
Sexual
Vertical

Question 22

How does Hep B present?

Answer 22

May be aysymptomatic esp for first 5 years

Question 23

How many adults clear infection?

Answer 23

> 90%

Question 24

How many children under 5 clear infection?

Answer 24

100%

Question 25

What are the antibody/antigen markers in Hep B?

Answer 25

HBcAb- Hepatitis Core antibody HBsAB- Hepatitis surface antibody HBsAg- Hepatitis Surface antigen HBeAg/Ab- Hepatitis

Question 26

What is serology of patients who have just been vacinated against Hep B?

Answer 26

Positiive HBsAb ONLY

Question 27

What is serology of patients who have had previous hep B?

Answer 27

Positive HBcAb and HBsAb ONLY

Question 28

What is the serology of patients who have chronic Hepatitis B?

Answer 28

Positive HBcAb and HBsAg | Pos or Neg HBaAg/Ab

Question 29

What is the hepatitis B vaccine?

Answer 29

Inactivated HBsAg

Question 30

What is PEP given in Hep B?

Answer 30

HBV Ig

Question 31

How is Hep B treated?

Answer 31

``` 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 ```

Question 32

What is the pneumonic for remembering Hepatitis?

Answer 32

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

Question 33

Which hepatitis coninfects with D?

Answer 33

B

Question 34

What is caused by infection with B and D?

Answer 34

Fulminant hepatitis and progressive liver disease