Hepatitis and hepatocellular carcinoma

Question 1

What are the causes of acute hepatitis?

Answer 1

1. Non-viral:
   - toxoplasma gondii
   - leptospirosis
   - coxiella burnetti
2. Viral:
   - EBV
   - Virus ABC(D)E - must have B to get D
   - CMV
   - Yellow fever
3. Drugs e.g. paracetamol
4. Alcohol
5. Pregnancy
6. Circulatory insufficiency
7. Wilson’s disease

Question 2

What are the RFs for hepatocellular carcinoma (HCC)

Answer 2

1. Liver cirrhosis
2. Alpha-1 antitrypsin deficiency
3. Hereditary tyrosinaemia
4. Glycogen storage disease
5. Drugs: OCP, anabolic disease

Question 3

What are the causes of liver cirrhosis

Answer 3

hepatitis B+C
alcohol
haemochromatosis
primary biliary cirrhosis

Question 4

How does HCC present?

Answer 4

LATE
Features of cirrhosis or failure:
- jaundice
- ascites
- RUQ pain 
- hepatomegaly
- pruritis
- splenomegaly

Question 5

What is the management of HCC?

Answer 5

Early disease: surgical resection 
Liver transplant 
Radiofrequency ablation 
Transarterial chemoembolism
Sorafenib