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Gastroenterology > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

WHat are LFTs in acute hepatitis?

A

Raised AST, ALT (GGT and ALP) and Billi

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2
Q

What are symptoms of acute hepatitis?

A 
Can be asymptomatic
Jaundice
Tender hepatomegaly
Malaise
GI upset
Pain
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3
Q

What are causes of acute hepatitis?

A 
Viral- A, B, EBV
Drugs
Alcohol
Vascular
Obstruction
Congestions
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4
Q

What are signs of chronic liver disease?

A 
Clubbing
Dupuytren's
Spider naeivi
Palmar erythema
LFTs normal
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5
Q

What is compensated chronic hepatitis?

A

Liver function maintained and LFTs normal

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6
Q

What is decompensated chronic hepatits signs?

A 
Ascites
Jaundice
Low Alb
Coagulopathy
Encephalopathy
Varices
Oedema
Itching
Easy Bruising
Anorexia
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7
Q

What are complications of chornic hepatits?

A

HCC
Portal hypertension
Varices and bleeding

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8
Q

What are causes of chronic hepatitis?

A 
Viral- B (+/-D), C
Alcohol
Drugs
Autoimmune (PSC, PBC)
Metabolic (Haemachromatosis, Wilson's, A1antitrypsin)
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9
Q

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

A

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

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10
Q

What is the commonest Hepatitis?

A

A

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11
Q

How is Hepatitis A spread?

A

Faeco oral

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12
Q

How is Hep A treated?

A

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

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13
Q

How do you get immunity to hep A

A

100% after infection

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14
Q

What is incubation period for Hep A?

A

2-3 weeks

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15
Q

How do you manage close contacts with Hep A?

A

HNIG Human normal immunoglobulin

NOTIFIABLE

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16
Q

Describe Hep E

A

RNA
Self limiting but chronic in immunocompromised
Faeco oral spread

17
Q

How is chronic hep E deteched?

A

HEV RNA

18
Q

What kind of virus is Hep B?

A

DNA Virus

19
Q

How long is the hep B incubation period?

A

6 months

20
Q

How infectiuos is hep B/

A

VERY

21
Q

How is Hep B spread?

A

Needlestick
Tattoos
Sexual
Vertical

22
Q

How does Hep B present?

A

May be aysymptomatic esp for first 5 years

23
Q

How many adults clear infection?

A

> 90%

24
Q

How many children under 5 clear infection?

A

100%

25
Q

What are the antibody/antigen markers in Hep B?

A

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

26
Q

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

A

Positiive HBsAb ONLY

27
Q

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

A

Positive HBcAb and HBsAb ONLY

28
Q

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

A

Positive HBcAb and HBsAg

Pos or Neg HBaAg/Ab

29
Q

What is the hepatitis B vaccine?

A

Inactivated HBsAg

30
Q

What is PEP given in Hep B?

A

HBV Ig

31
Q

How is Hep B treated?

A 
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
32
Q

What is the pneumonic for remembering Hepatitis?

A

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

33
Q

Which hepatitis coninfects with D?

A

B

34
Q

What is caused by infection with B and D?

A

Fulminant hepatitis and progressive liver disease

Gastroenterology (17 decks)

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