Hepatitis B

Question 1

What is the typical history associated with hepatitis B?

Answer 1

Fatigue, anorexia, nausea, vomiting. Right upper quadrant pain. Dark urine, pale stools, jaundice. History of unprotected sex, IV drug use, or travel to endemic areas.

Question 2

What are the key physical examination findings in hepatitis B?

Answer 2

Jaundice, hepatomegaly. Right upper quadrant tenderness. Ascites or signs of chronic liver disease in advanced cases.

Question 3

What investigations are necessary for diagnosing hepatitis B?

Answer 3

Elevated liver enzymes (ALT, AST). Positive HBsAg (hepatitis B surface antigen). Positive anti-HBc IgM (acute infection) or IgG (chronic infection). HBV DNA for viral load.

Question 4

What are the non-pharmacological management strategies for hepatitis B?

Answer 4

Rest and hydration. Avoid alcohol and hepatotoxic drugs. Educate on safe sex practices and avoiding sharing needles.

Question 5

What are the pharmacological management options for hepatitis B?

Answer 5

Antiviral therapy for chronic hepatitis B (e.g., entecavir, tenofovir). Pegylated interferon for some patients. Symptomatic treatment for acute infection.

Question 6

What are the red flags to look for in hepatitis B patients?

Answer 6

Severe abdominal pain, persistent vomiting. Signs of acute liver failure: confusion, severe jaundice, bleeding tendencies. Signs of chronic liver disease: ascites, variceal bleeding.

Question 7

When should a patient with hepatitis B be referred to a specialist?

Answer 7

Chronic hepatitis B with elevated liver enzymes or viral load. Signs of cirrhosis or liver failure. Coinfection with hepatitis C or HIV. Pregnant women with hepatitis B.

Question 8

What is one key piece of pathophysiology related to hepatitis B?

Answer 8

Caused by hepatitis B virus (HBV), a DNA virus. Transmitted via blood, sexual contact, and perinatally. Virus infects hepatocytes, leading to liver inflammation, fibrosis, and potential cirrhosis or hepatocellular carcinoma.