Hepatitis, Autoimmune & Transplant

Question 1

what hepatitis infections are self limiting and acquired from food and water?

Answer 1

hep A and e

Question 2

What hepatitis infections are acquired through blood and exposure?

Answer 2

hep B, C and D

Question 3

regarding blood tests, what does hepatitis show a rapid rise in?

Answer 3

ALT and IgM

Question 4

Immunisation against hep A is given to who?

Answer 4

travellers
patients with chronic live disease
haemophiliacs 
occupational exposures (e.g. lab workers)
men who have sex with men

Question 5

what type of hepatitis produces many antigens ? and what are these?

Answer 5

hepatitis B
surface antigen - HBsAg
E antigen - HBeAg
Core antigen - HBcAg
HBV DNA

Question 6

which antibody indicates acute infection of hep B and which one indicated chronic infection?

Answer 6

IgM anti-HBc

IgG anti-HBc

Question 7

what antibody provides protection from further Hep B infection?

Answer 7

Anti-HBs

Question 8

what can occur as a long term consequence of hep B infection?

Answer 8

if its chronic HBV then it can progress to cirrhosis which can progress to end stage liver disease and/or hepatocellular carcinoma

Question 9

what are the drug types which are used to treat hep b?

Answer 9

oral antiviral drugs
pegylated interferon (PEG INF)

Question 10

what hepatitis infection mostly (80%) causes chronic infection?

Answer 10

hepatitis C

Question 11

What is the treatment for hep C?

Answer 11

PEG INF + ribavirin
simeprevir
sofosbuvir (+ledipsavir)
declatasvir

Question 12

what hep virus does the hep D virus infect and how?

Answer 12

hep D doesn’t code for its own protein coat - it envelopes in hep B’s antigen - HBsAG

Question 13

what hepatitis infection can only occur if you have already got hep C?

Answer 13

Hep D

Question 14

what hep infection is the commonest type for acute hep infection n the uk?

Answer 14

hep E

Question 15

What autoimmune liver disease mainly affects males?

Answer 15

primary sclerosis cholangitis

Question 16

what autoimmune liver disease causes elevated IgM?

Answer 16

primary biliary cholangitis

Question 17

what antigen does autoimmune hepatitis show a rise in?

Answer 17

IgG

Question 18

What gene is indicative of primary sclerosis cholangitis?

Answer 18

pANCA

Question 19

what is the treatment of autoimmune hepatitis?

Answer 19

steroids

long term azathioprine

Question 20

what autoimmune disease presents with fatigue and pruritus?

Answer 20

primary biliary cholangitis

Question 21

what is the treatment for PBC?

Answer 21

ursodeoxycholic acid

Question 22

what are the symptoms of primary sclerosis cholangitis?

Answer 22

recurrent cholangitis

jaundice

Question 23

how is PSC diagnosed and treated?

Answer 23

diagnosed by MRCP

treatment - biliary stent, liver transplant

Question 24

how i autoimmune hepatitis diagnosed?

Answer 24

liver biopsy

Question 25

what are the anti rejection drugs given if someone has a liver transplant?

Answer 25

steroids
azathioprine
tacrolimus/cyclosporin

Question 26

what patients are given a liver transplant?

Answer 26

chronic liver disease associated with poor quality of life
chronic liver disease with poor predicted survival
hepatocellular carcinoma
acute liver failure
genetic disease e.g. primary oxaluria, tyrosemia

Question 27

name a few of the contraindications for liver transplant.

Answer 27

active extra hepatic malignancy
intrahepatic malignancy with microvascular or diffuse tumour invasion
active / uncontrolled infection
active substance/alcohol abuse
brain death
severe co-morbidities i.e. cardiopulmonary

Question 28

what can having hepatitis put you at risk of developing?

Answer 28

hepatocellular carcinoma

Question 29

what scoring system is used for prioritising patients for transplantation when they have cirrhosis?

Answer 29

child pugh scoring (A, B & C)