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Junior Medicine- GI > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

What are the causes of hepatitis?

A
  • Autoimmune
  • NAFLD (NASH)
  • Viral Hepatitis
  • Alcoholic hepatitis
  • Drug induced hepatitis (Paracetamol OD)
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2
Q

How does hepatitis present?

A

Asymptomatic or Non-specific:

  • Fatigue
  • Abdo pain
  • Pruritis
  • Muscle and joint aches
  • N&V
  • Jaundice
  • Fever
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3
Q

What are the typical LFT findings in hepatitis

A

‘Hepatic Picture’:

  • Raised transaminases
  • ALP not as raised
  • Raised bilirubin
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4
Q

When are transaminases released?

A

When the liver is inflamed

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5
Q

What is the most common viral hepatitis worldwide?

A

Hep A- but not very common in the UK

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6
Q

How does HepA spread?

A

Faecal-Oral

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7
Q

How does HepA present?

A
  • N&V
  • Anorexia
  • Jaundice
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8
Q

How does HepA resolve?

A

Self-resolves in 1-3 months

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9
Q

How is HepA treated?

A

Analgesia

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10
Q

What can HepA cause?

A

Cholestasis

  • Pale stools
  • Dark urine
  • Mild hepatomegaly
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11
Q

What should you do once discovering any viral hepatitis?

A

Notify public health

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12
Q

How does HepB spread?

A

Vertically or with Bodily fluids:

  • Sex
  • IVDU
  • Contaminated household products e.g. toothbrush
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13
Q

How long does it take people to recover from HepB?

A

2 months

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14
Q

How many HepB sufferers go on to be chronic carriers and why?

A

10%- virus’ DNA integrates into the host DNA, so viral proteins produced

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15
Q

What does Surface antigen (HBsAg) indicate?

A

Active infection

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16
Q

What does E antigen (HBeAg) indicate?

A

High infectivity

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17
Q

What does Core antibodies (HBcAb) indicate?

A

Past infection (Or current)

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18
Q

What does Surface antibody (HBsAb) indicate?

A

Vaccination (Or infection)

19
Q

What does Hepatitis B virus DNA (HBV DNA) indicate?

A

Viral load

20
Q

When screening for hepatitis, which tests are done first?

A
  • Surface antigen
  • Core antibody

(Current or previous infection)

21
Q

If the first hepatitis screen is positive, which tests follow?

A
  • e Antigen
  • Viral load

(Is it actively replicating and how much is there)

22
Q

Which immunoglobulin indicates active infection?

A

IgM

23
Q

Which immunoglobulin indicates previous infection?

A

IgG

24
Q

What is in the HepB vaccine?

A

Surface Antigen

25
Q

How is HepB treated?

A
  • Education, alcohol abstinence
  • Low threshold for screening high risk Pts e.g. IVDUs
  • Test for complications e.g. FibroScan
  • Antivirals to slow progression and reduce infectivity
26
Q

How is HepC spread?

A

Bodily fluids

27
Q

What proportion will fight off the HepC virus vs become chronic carriers?

A

1/4 fight off

3/4 carry

28
Q

How is HepC treated?

A

Direct acting anti-virals

29
Q

How long are anti-virals taken for in HepC?

A

8-12 weeks

30
Q

How successful are HepC ant-virals?

A

90%

31
Q

How is HepD spread?

A

ONLY in co-infection with HepB

32
Q

How does HepD survive?

A

Attaches to HBsAg

33
Q

How does HepE spread?

A

Faecal-oral

34
Q

What is the disease course of HepE?

A
  • Very mild, requires no treatment
  • Clears in a month
  • Very rare in the UK
35
Q

What can all hepatitis lead to?

A

Cirrhosis and Hepatocellular Carcinoma

36
Q

Which viral hepatitises are RNA?

A

A, C, D, E

37
Q

Which viral hepatitis is DNA?

A

B

38
Q

What are the two types of autoimmune hepatitis?

A

1- Only in adults (post-menopausal women)

2- Only in children/young adults

39
Q

Which type of AI hepatitis is more acute?

A

Type 2

40
Q

Which autoABs can cause type 1 AI hep?

A
  • ANA
  • Anti-actin (Anti-SM)
  • Anti-soluble liver antigen (anti-SLA/LP)
41
Q

Which autoABs can cause type 2 AI hep?

A
  • Anti-liver kidney microsomes-1 (anti-LKM1)

- Anti-liver cytosol antigen type 1 (anti-LC1)

42
Q

How is AI hepatitis diagnosed?

A

Biopsy

43
Q

How is AI hepatitis treated?

A

1- High dose prednisolone

taper down, introduce

2- Azathioprine

44
Q

Can AI hepatitis be transplanted?

A

Yes but it may recur

Junior Medicine- GI (18 decks)

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