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Infectious diseases > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

Viral hep

A

Inform public health

A, B, C and E

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2
Q

Hepatotrophic

A

Mainly affect liver

A, B, C, D, E

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3
Q

Hep A symptoms

A 
incubation 28 days
Fever
Malaise
Anorexia
Nausea
Vomiting
Upper abdo pain
Jaundice
Dark urine
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4
Q

Hep A route

A

Faecal oral

Faecal contaminated food or water

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5
Q

Hep A risk UK

A

Men having sex with men

Injecting drugs

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6
Q

Hep A treatment

A

No cure but there is a vaccine which mostly works after 2 weeks
Second booster given 20 years after first if ongoing risk

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7
Q

Who gets immunised hep A

A 
Sewage workers
Seronegative haemophilliacs
Gay men with multiple partners
Travelling to endemic areas
PWID
Patients w chronic liver disease
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8
Q

Hep B symptoms

A 
Few weeks to 6 months
Anorexia
Lethargy
Nausea
Fever
Abdo discomfort
Arthralgia
Urticarial skin lesions
Jaundice
Dark urine
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9
Q

Hep B transmission

A

Verticle (perinatal)

Horizontal (sexual, needles)

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10
Q

Hep B risks

A

IVDU
Multiple sexual partners
Patients w learning difficulties
Patients w haemophilia or in haemodialysis units
Babies born to mother at risk
Tattoos or piercings non sterile
Medical equipment not adequately decontaminated

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11
Q

Test for hep B

A

HBsAg positive in serum

anti- HBc IgM if later

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12
Q

Chronic HBV

A

Persistent HBsAg in serum for more than 6 months

Highest risk if infant and high if child

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13
Q

Chronic HBV follow on

A

Chronic liver disease
Cirrhosis and hepatoma
Membranous glomerulonephritis
Poluarteritis nodosa

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14
Q

Chronic HBV treatment

A

If raised ALT and HBeAg pos w progressing liver disease
Give anti viral therapy aimed at HBV replication
If cirrhosis and evidence viral replication give anti virals
If no cirrosis need 2 of;
HBV DNA>2000IU/ml
Raised ALT
signif liver inflam or fibrosis

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15
Q

Anti virals

A

Pegylated alpha interferon subcut
Entecavir and tenofovir
Liver transplant is severe

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16
Q

Immunisations active

A 
Test for antibodies 2-4 mnths later for certian groups like HCW
HCWs
Travel to endemic areas for prolonged stay over 1 year
Renal dialysis patients
Incr sexual partners frequency
PWID
Police and emergency services at risk
Close contacts of those with chronic HBV
17
Q

Passive immunosations

A

Infants bron to mothers with chronic HBV
HCWs not known to ave adequare levels of anti HBs
Prev unprotected sexual contacts or family of those with acute or chronic HBV

18
Q

HBV propylaxis

A

HBsAg pos and on chemo need to be referred to specialised clinic

19
Q

Hep c symptoms

A 
Vague malaise
Anorexia
Fatigue
Jaundice is severe
Usually subclinical or milk
20
Q

Hep C tests

A

AST and ALT to check for chronic progression

Increased AST:ALT ratio shows fibrosis/cirrhosis

21
Q

Hep C transmission

A

Blood borne

22
Q

Hep C risks

A

Sexual contact and mother to child is low unless mother pos HIV
Higher in japan, new guinea, gambua, zaire
higher in UK if IVDU or haemophilliacs
Healthcare staff at risk
Alcohol excess

23
Q

Hep C routes transmission

A 
IV drugs
Blood products prior to heat treatment
Blood transfusions before antibdot screening
Tattoos and peircings
Sexual trans 
Mother to child
Sharing razors/toothbrushes
Medical equipment not fully cleaned
24
Q

Hep C treatment

A

Aplha interferon and ribavirin

Drugs that inhibit HCV protease enzyme

25
Q

Hep D

A

Always found w hep B

Can occur alongside hep B or after hep B infection

26
Q

Hep D transmission

A

IVDU commonest

Family/sex less likely

27
Q

Hep D diagnosis

A

IgG and IgM to HDV

HDV-RNA and HDVAg in serum

28
Q

Hep D treat

A

Pegylated alpha interferon

Liver transplant

29
Q

Hep E symptoms

A

Symptoms after 40 days
Clinically resembles HAV apart from incr incidence of fulminant infection w high mortality in pregnant women
In UK normally subclin or mild in women and young people w severe in elderly men
May oresent w arthirits, anaemia and neurological manifestations

30
Q

Hep E development

A

Liver failure esp if pre existing liver disease

31
Q

Hep E investigations

A

Serology IgG and IgM
HEVRNA
No licenced treatment and usually self limiting

Infectious diseases (17 decks)

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