Hepatitis

Question 1

Types of hepatitis

Answer 1

Viral - A, B, C, D, E
Alcoholic
Autoimmune

Question 2

Symptoms/signs of hepatitis

Answer 2

3 corners of the liver

• fever
• jaundice
• raised ALT/AST

Question 3

Viral hepatitis Ix

Answer 3

Bloods (FBC, LFTs, U&Es)
Clotting
US scan (cancer)
Viral serology
Viral PCR
Liver biopsy (degree of inflammation/liver damage, useful in cirrhosis)

Question 4

Prolonged PT

Answer 4

Sensitive marker of significant liver damage (as now impaired function)

Question 5

Faeco-oral hepatitides

Answer 5

Hep A & E (the vowels hit your bowels)

Question 6

Uncleaned shellfish from contaminated water

Answer 6

Hepatitis A (HAV transmission)

Question 7

Mostly asymptomatic, symptoms take around 2-6 weeks to develop and last roughly 8 weeks including:

• N/V/(D)
• fever
• jaundice
• abdo pain (esp RUQ)

Answer 7

Hepatitis A

Question 8

Management of Hep A

Answer 8

Supportive with avoidance of alcohol

- small chance of acute liver failure which requires a liver transplant

Question 9

Acute and self-limiting hepatitis with immunocompromised patients and expectant mothers at risk of chronic infection

Answer 9

Hepatitis E

Question 10

Management of Hep E

Answer 10

Supportive with avoidance of alcohol

Question 11

Nausea, anorexia, RUQ pain, jaundice on Hx of IV drug use and unprotected sex

Answer 11

Hepatitis B

Question 12

Hep B chronic infection chance

Answer 12

10%, much more of an acute condition (one of the differences between HBV and HCV)

Question 13

Transmission of HBV

Answer 13

Baby-making (unprotected sex, MSM)
Blood (transfusion, IVDU)
Birthing (perinatal)

Question 14

Management of Hep B

Answer 14

Acute - symptom supportive

Chronic - anti-virals (peginterferon alpha)

Question 15

Which hepatitis co-exists with another?

Answer 15

Hep D with Hep B

- needs Hep B surface antigens to enter hepatocytes

Question 16

Almost all cases asymptomatic but occasionally experience typical hepatitis symptoms, spread primarily through contaminated blood products

Answer 16

Hep C

Question 17

Chronic hepatitis that is a risk factor for hepatocellular cancer (fibrosis to cirrhosis to cancer)

Answer 17

Hep C

- asymptomatic nature means pts are often unaware of infection

Question 18

Hep C chronic infection chance

Answer 18

80%

Question 19

Management of Hep C

Answer 19

Antiretrovirals (MS5A inhibitors, NS3/4 protease inhibitors)

Question 20

Differences between Hep B and Hep C

Answer 20

DNA virus - RNA virus
Bodily fluids - Blood
Acute - Chronic
Hep D - No other Hep
Vaccine - No vaccine
Supportive Mx - Antiretrovirals