Hepatitis, Autoimmune & Transplant Flashcards
what hepatitis infections are self limiting and acquired from food and water?
hep A and e
What hepatitis infections are acquired through blood and exposure?
hep B, C and D
regarding blood tests, what does hepatitis show a rapid rise in?
ALT and IgM
Immunisation against hep A is given to who?
travellers patients with chronic live disease haemophiliacs occupational exposures (e.g. lab workers) men who have sex with men
what type of hepatitis produces many antigens ? and what are these?
hepatitis B surface antigen - HBsAg E antigen - HBeAg Core antigen - HBcAg HBV DNA
which antibody indicates acute infection of hep B and which one indicated chronic infection?
IgM anti-HBc
IgG anti-HBc
what antibody provides protection from further Hep B infection?
Anti-HBs
what can occur as a long term consequence of hep B infection?
if its chronic HBV then it can progress to cirrhosis which can progress to end stage liver disease and/or hepatocellular carcinoma
what are the drug types which are used to treat hep b?
oral antiviral drugs pegylated interferon (PEG INF)
what hepatitis infection mostly (80%) causes chronic infection?
hepatitis C
What is the treatment for hep C?
PEG INF + ribavirin
simeprevir
sofosbuvir (+ledipsavir)
declatasvir
what hep virus does the hep D virus infect and how?
hep D doesn’t code for its own protein coat - it envelopes in hep B’s antigen - HBsAG
what hepatitis infection can only occur if you have already got hep C?
Hep D
what hep infection is the commonest type for acute hep infection n the uk?
hep E
What autoimmune liver disease mainly affects males?
primary sclerosis cholangitis
what autoimmune liver disease causes elevated IgM?
primary biliary cholangitis
what antigen does autoimmune hepatitis show a rise in?
IgG
What gene is indicative of primary sclerosis cholangitis?
pANCA
what is the treatment of autoimmune hepatitis?
steroids
long term azathioprine
what autoimmune disease presents with fatigue and pruritus?
primary biliary cholangitis
what is the treatment for PBC?
ursodeoxycholic acid
what are the symptoms of primary sclerosis cholangitis?
recurrent cholangitis
jaundice
how is PSC diagnosed and treated?
diagnosed by MRCP
treatment - biliary stent, liver transplant
how i autoimmune hepatitis diagnosed?
liver biopsy
what are the anti rejection drugs given if someone has a liver transplant?
steroids
azathioprine
tacrolimus/cyclosporin
what patients are given a liver transplant?
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
name a few of the contraindications for liver transplant.
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
what can having hepatitis put you at risk of developing?
hepatocellular carcinoma
what scoring system is used for prioritising patients for transplantation when they have cirrhosis?
child pugh scoring (A, B & C)
