Hepatitis

Question 1

Acute hepatitis is usually symptomatic. T/F?

Answer 1

True

Question 2

How is chronic hepatitis defined?

Answer 2

Hepatitis virus which is present for more than 6 months

Question 3

Chronic hepatitis is usually symptomatic. T/F?

Answer 3

False - it is usually asymptomatic

Question 4

What are the routes of transmission of hepatitis virus?

Answer 4

Facial oral route

Blood borne

Question 5

What can cause hepatitis?

Answer 5

Hepatitis A,B,C,D,E
EBV,CMV,t toxoplasmosis
leptospirosis
Q fever
syphilis
malaria
VHF
toxins
drugs
alcohol
autoimmune
wilson's disease
haemochromatosis

Question 6

Which strains of hepatitis are RNA viruses?

Answer 6

Hepatitis A,C,D,E

Question 7

Which strain of hepatitis is a DNA viruses?

Answer 7

Hepatitis B

Question 8

How is hepatitis A transmitted?

Answer 8

Faecal-oral route and has a human reservoir

Question 9

There is chronic carriage of hepatitis A. T/F?

Answer 9

False

Question 10

In what group of patients can there be chronic carriage of hepatitis E?

Answer 10

In immunosuppressed patients

Question 11

How is chronic hepatitis E treated?

Answer 11

Ribavirin

Question 12

What is the incubation period for hepatitis A?

Answer 12

30 days

Question 13

There is good immunity after infection of hepatitis A. T/F?

Answer 13

True

Question 14

How does age determine the severity of hepatitis A infection?

Answer 14

It is usually symptomatic in children <5 years and is symptomatic in adults

Question 15

How is hepatitis A infection treated?

Answer 15

No specific treatment as it is self limiting

Maintain hydration and avoid alcohol

Question 16

What tests will be positive in acute hepatitis A?

Answer 16

IgM positive

Hepatitis A in blood or stool

Question 17

What test will be positive in previous HAV infection?

Answer 17

IgG

Question 18

Who is the hepatitis A vaccine given to?

Answer 18

Homosexual men
IVDUs
Chronic liver disease

Question 19

What type of vaccine is the hepatitis A vaccine?

Answer 19

Inactivated virus vaccine

Question 20

What can be used as an alternative to vaccination for hepatitis A in those with <4 weeks to travel or those who are vaccine allergic?

Answer 20

Hepatitis immunoglobulin

Question 21

How can hepatitis E be transmitted?

Answer 21

Faecal-oral toute, pork products, minimal person-to-person spread

Question 22

In what group of patients is mortality from hepatitis E highest?

Answer 22

Pregnant women

Question 23

What are the possible neurological complications of hepatitis E infection?

Answer 23

Guillain-barre syndrome
Encephalitis
Ataxia
Myopathy

Question 24

What genotype of hepatitis E is particularly associated with neurological complications?

Answer 24

GT3

Question 25

HBV vaccination is given routinely in most countries. T/F?

Answer 25

True

Question 26

How can HBV be transmitted?

Answer 26

``` Transfusion Fluid Organ/tissue transplantation Child to child Contaminated needles/syringes Mother to baby ```

Question 27

What is the incubation period of hepatitis B?

Answer 27

2-6 months

Question 28

How does age determine the severity and chronicity of hepatitis A infection?

Answer 28

Infection at birth or childhood is usually asymptomatic but leads to chronic infection Infection as an adult is usually symptomatic but is cleared

Question 29

What are the signs and symptoms of hepatitis B?

Answer 29

Weight loss, abdominal pain, fever, cachexia, mass in abdomen and bloody ascites

Question 30

What are the potential complications of HBV?

Answer 30

Cirrhosis Decompensation Hepatocellular carcinoma Death

Question 31

In HBV serology testing, what is a marker of current infection?

Answer 31

sAg

Question 32

In HBV serology testing, what is a marker of immunity due to either previous infection or vaccination?

Answer 32

sAb

Question 33

In HBV serology testing, what is only positive in patient swoon have have infection (previous or current) and not in vaccination?

Answer 33

cAb

Question 34

In HBV serology testing, what indicates high infectivity?

Answer 34

eAg

Question 35

In HBV serology testing, what indicates low infectivity?

Answer 35

eAb

Question 36

How is acute HBV treated?

Answer 36

It is not treated as it usually resolves and clears

Question 37

Which patients require treatment for chronic HBV?

Answer 37

Those with liver inflammation (seen on LFT or biopsy) or fibrosis (seen on fibroscan or biopsy)

Question 38

What is the possible treatment for HBV?

Answer 38

Interferon (immunomodulatory) | Tenofevir/entecavir which suppress viral replication

Question 39

How is HBV infection prevented?

Answer 39

Education (e.g. safe sex, injecting) Immunisation with the HBV sAg vaccine Prevention of mother to child transmission

Question 40

How is mother to child transmission of HBV prevented?

Answer 40

HBV vaccination given to the newborn in 6 doses immediately after birthHBV immunoglobulin if eAg positive Tenofeovir during last trimester if high viral load

Question 41

Hepatitis D requires infection with what other virus in order to replicate?

Answer 41

Hepatitis B

Question 42

Hepatitis D increases the risk of chronic liver disease. T/F?

Answer 42

True

Question 43

How is hepatitis D infection managed?

Answer 43

Interferon only

Question 44

How is hepatitis C transmitted?

Answer 44

Transfusion/transplant | vertical or sexual transmission is rare

Question 45

There is a vaccine for hepatitis C. T/F?

Answer 45

False

Question 46

What is the incubation period of hepatitis C?

Answer 46

6-7 weeks

Question 47

HCV is usually symptomatic. T/F?

Answer 47

False - it is usually symptomatic

Question 48

What does the presence of IgG for HCV indicate?

Answer 48

Chronic HCV infection or cleared infection

Question 49

What tests are used to assess for current HCV infection?

Answer 49

PCR or antigen tests

Question 50

How is HCV treated?

Answer 50

Direct acting antiviral which inhibit the replication cycle

Question 51

For how long is DAA treatment used in HCV?

Answer 51

8-12 weeks

Question 52

How are direct acting antivirals for HCV infection often dispensed?

Answer 52

From community pharmacies with daily methadone on an observed basis