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A. MLA Map Paediatrics > Hepatitis B > Flashcards

Hepatitis B Flashcards

1
Q

Hepatitis B is a viral infection causing inflammation of the liver. What is the incidence of hep B?

1 - 0.80 cases per 100,000
2 - 80 cases per 100,000
3 - 800 cases per 100,000
4 - 8000 cases per 100,000

A

1 - 0.80 cases per 100,000

Equally as likely to infect men and women

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2
Q

Hepatitis B is a viral infection causing inflammation of the liver. At what age does the incidence of hep B peak?

1 - 20-30
2 - 30-40
3 - 40-50
4 - 60-70

A

2 - 30-40

Older sexually active individuals

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3
Q

Are viral hepatitis notifiable diseases?

A
  • Yes

All viral hepatitis are notifiable

UK Health Security Agency need to be alerted

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4
Q

Hepatitis B is a virus causing inflammation of the liver. Which of the following is NOT a mode of transition of this virus?

1 - sexual activity
2 - faecal oral
3 - needle sharing
4 - childbirth

A

2 - faecal oral

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5
Q

Which of the following is NOT a common location where hepatitis B is common?

1 - Asia
2 - Africa
3 - North America
4 - South America
5 - Caribbean

A

3 - North America

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6
Q

What is the incubation period of hepatitis B?

1 - <11 days
2 - 11-21 days
3 - 30-50 days
4 - 30-180 days

A

4 - 30-180 days

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7
Q

Do all patients with hepatitis B present with symptoms?

A
  • No

The majority, around 70% are asymptomatic

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8
Q

When a patient becomes infected by hepatitis B, which of the following symptoms do they typically present with?

1 - Abdominal pain
2 - Fatigue with Flu-like illness
3 - Pruritus (itching)
4 - Muscle and joint aches
5 - Nausea and vomiting
6 - Jaundice
7 - All of the above

A

7 - All of the above

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9
Q

When trying to diagnose a patient with hepatitis B, we can run some liver tests.Which of the following is correct?

1 - rise in AST, ALT and ALP
2 - drop in AST, ALT and ALP
3 - rise in AST and ALP, drop in ALT
4 - rise in AST and ALT, normal or small rise in ALP

A

4 - rise in AST and ALT, normal or small rise in ALP

ALT and AST are transaminases, liver enzymes that are released into the blood due to inflammation of the liver cells. ALP is NOT

ALP is likely to rise, but out of proportion to AST and ALT rises

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10
Q

In hepatitis, in addition to large rises in ALT and AST as a marker of liver inflammation, which marker is the best for liver damage due to the viral damage and liver inflammation?

1 - CRP
2 - albumin
3 - ALP
4 - bilirubin

A

4 - bilirubin

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11
Q

In severe cases of hepatitis B, which of the following measures is least likely to be affected?

1 - bilirubin
2 - albumin
3 - clotting factors
4 - sodium

A

4 - sodium

Could be affected if severe ascites due to fluid overload

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12
Q

When testing for hepatitis, we can use antigen and antibody testing. If raised, which of the following would indicate an active infection of hepatitis B?

1 - HBs Ag
2 - Anti HBe Ab
3 - HBe Ag
4 - Anti HBc AB

A

1 - HBs Ag

Could also be raised in chronic infection

H = hepatitis
B = B virus
s = surface
Ag = antigen

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13
Q

When testing for hepatitis, we can use antigen and antibody testing. If raised, which of the following is a measure of viral load in the blood?

1 - HBs Ag
2 - Anti HBe Ab
3 - HBe Ag
4 - Anti HBc AB

A

3 - HBe Ag

H = hepatitis
B = B virus
e Ag = antigen

The antigen is essentially part of the virus in the blood

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14
Q

When testing for hepatitis, we can use antigen and antibody testing. If raised, which of the following would indicate a previous or ongoing contact with hepatitis B?

1 - HBs Ag
2 - HBe Ab
3 - HBe Ag
4 - HBc Ab

A

4 - HBc Ab

H = hepatitis
B = B virus
c = core antibodies
Ab = antibodies

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15
Q

When testing for hepatitis, we can use antigen and antibody testing. If raised, which of the following would indicate vaccination or remission of the hepatitis B infection?

1 - HBs Ab
2 - HBe Ab
3 - HBe Ag
4 - HBc Ab

A

1 - HBs Ab

H = hepatitis
B = B virus
s = surface antigens
Ab = antibodies

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16
Q

When testing for hepatitis, we can use antigen and antibody testing. If raised, which of the following would indicate low hepatitis viral replication and remission?

1 - HBs Ab
2 - HBe Ab
3 - HBe Ag
4 - HBc Ab

A

2 - HBe Ab

H = hepatitis
B = B virus
e = antigens in blood
Ab = antibodies

17
Q

When testing for hepatitis, we can use antigen and antibody testing. Which of the following is a measure of the direct viral load?

1 - HBs Ag
2 - HBe Ab
3 - HBV DNA
4 - HBc Ab

A

3 - HBV DNA

18
Q

When testing for hepatitis B, which of the following antibodies suggests an acute infection?

1 - IgA
2 - IgD
3 - IgM
4 - IgG
5 - IgE

A

3 - IgM

First antibody in the blood to appear following infection

19
Q

When testing for hepatitis B, which of the following antibodies suggests an acute infection?

1 - IgA
2 - IgD
3 - IgM
4 - IgG
5 - IgE

A

4 - IgG

Second antibody present, typically this has been tailored to the virus it is fighting, hence why its not the first antibody

20
Q

Is liver ultrasound used in diagnosis?

A
  • no

Maybe used for chronic disease though

21
Q

In patients with a confirmed diagnosis of hepatitis B, which 2 of the following is correct?

1 - liver function every 3-6 months in acute infection
2 - liver ultrasound every 6-months if acute infection
3 - liver function every 3-6 months in chronic infection
2 - liver ultrasound every 6-months if chronic infection or high risk liver complications

A

3 - liver function every 3-6 months in chronic infection
2 - liver ultrasound every 6-months if chronic infection or high risk liver complications

22
Q

Which of the following is NOT a likely differential for hepatitis B?

1 - hepatitis A, C and E
2 - cholelithiasis
3 - alcoholic hepatitis
4 - ascending cholangitis
5 - autoimmune hepatitis

A

2 - cholelithiasis
This is gall stones

23
Q

What is the management for an acute hepatitis B infection?

1 - vaccination]
2 - supportive management
3 - entecavir or tenofovir
4 - liver transplant

A

2 - supportive management

Only 5% of patients progress to chronic hepatitis B

Entecavir or tenofovir are the drugs of choice in an acutely infected patient

24
Q

Is there a vaccine for hepatitis B?

A
  • yes

3 doses of the hepatitis B antigen are required
Tested for surface antibody to confirm immunisation

25
Q

When is the hepatitis B vaccine given?

1 - 8 weeks
2 - 12 weeks
3 - 16 weeks
4 - all of the above

A

4 - all of the above

Given as part of the 1 in 6 vaccine

26
Q

When managing a patient who has been diagnosed with hepatitis B, which of the following must be implemented:

1 - Partner Notification & Treatment
2 - Education, health promotion
3 - Abstinence – 7 days AND until partner treated
4 - Antibiotic treatment and no alcohol
5 - Condoms
6 - Prevention and risk reduction
7 - all of the above

A

7 - all of the above

27
Q

If a patient develops chronic hepatitis B, which 2 of the following vaccinations should they receive?

1 - hepatitis A vaccine
2 - pneumococcql vaccine
3 - influenza vaccine (annual)
4 - polio vaccine

A

1 - hepatitis A vaccine
3 - influenza vaccine (annual)

28
Q

32 years, male, presents with poor appetite, jaundice, tiredness for 4 weeks, but not other symptoms. No previous medical history or foreign travel, but he had sex with a sex worker 3 months ago.

Which aspects of the history make you suspect hepatitis B?

A
  • Jaundice and fatigue
  • Sex with a sex worked as hepatitis B can be transmitted sexually
29
Q

32 years, male, presents with poor appetite, jaundice, tiredness for 4 weeks, but not other symptoms. No previous medical history or foreign travel, but he had sex with a sex worker 3 months ago. His blood results are attached.

Which aspects of the results make you make you suspect hepatitis B?

A
  • ALT (alanine transaminase): 1250 U/L (normal range: 0-50)
  • Total Bilirubin: 82 umol/L (normal range: 0-22)
  • Ultrasound abdomen: mild hepatomegaly
30
Q

32 years, male, presents with poor appetite, jaundice, tiredness for 4 weeks, but not other symptoms. No previous medical history or foreign travel, but he had sex with a sex worker 3 months ago. His hepatitis B serology results are attached.

Which aspects of the results make you make you suspect acute hepatitis B?

A

Hepatitis B surface antigen: Detected = Hep B present

Hepatitis B core total antibody: Detected = Antibodies produced and active infection

Hepatitis B core IgM: Detected = acute infection as IgM are first antibodies produced

HBV DNA: 467,000 IU/ml (IU: International Units; ml: millilitre) = high viral load as in acute infection

31
Q

Can patients with hepatitis B breastfeed?

A
  • yes

A. MLA Map Paediatrics (75 decks)

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