Hepatitis B Flashcards
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
1 - 0.80 cases per 100,000
Equally as likely to infect men and women
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
2 - 30-40
Older sexually active individuals
Are viral hepatitis notifiable diseases?
- Yes
All viral hepatitis are notifiable
UK Health Security Agency need to be alerted
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
2 - faecal oral
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
3 - North America
What is the incubation period of hepatitis B?
1 - <11 days
2 - 11-21 days
3 - 30-50 days
4 - 30-180 days
4 - 30-180 days
Do all patients with hepatitis B present with symptoms?
- No
The majority, around 70% are asymptomatic
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
7 - All of the above
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
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
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
4 - bilirubin
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
4 - sodium
Could be affected if severe ascites due to fluid overload
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
1 - HBs Ag
Could also be raised in chronic infection
H = hepatitis
B = B virus
s = surface
Ag = antigen
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
3 - HBe Ag
H = hepatitis
B = B virus
e Ag = antigen
The antigen is essentially part of the virus in the blood
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
4 - HBc Ab
H = hepatitis
B = B virus
c = core antibodies
Ab = antibodies
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
1 - HBs Ab
H = hepatitis
B = B virus
s = surface antigens
Ab = antibodies
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
2 - HBe Ab
H = hepatitis
B = B virus
e = antigens in blood
Ab = antibodies
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
3 - HBV DNA
When testing for hepatitis B, which of the following antibodies suggests an acute infection?
1 - IgA
2 - IgD
3 - IgM
4 - IgG
5 - IgE
3 - IgM
First antibody in the blood to appear following infection
When testing for hepatitis B, which of the following antibodies suggests an acute infection?
1 - IgA
2 - IgD
3 - IgM
4 - IgG
5 - IgE
4 - IgG
Second antibody present, typically this has been tailored to the virus it is fighting, hence why its not the first antibody
Is liver ultrasound used in diagnosis?
- no
Maybe used for chronic disease though
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
3 - liver function every 3-6 months in chronic infection
2 - liver ultrasound every 6-months if chronic infection or high risk liver complications
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
2 - cholelithiasis
This is gall stones
What is the management for an acute hepatitis B infection?
1 - vaccination]
2 - supportive management
3 - entecavir or tenofovir
4 - liver transplant
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
Is there a vaccine for hepatitis B?
- yes
3 doses of the hepatitis B antigen are required
Tested for surface antibody to confirm immunisation
When is the hepatitis B vaccine given?
1 - 8 weeks
2 - 12 weeks
3 - 16 weeks
4 - all of the above
4 - all of the above
Given as part of the 1 in 6 vaccine
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
7 - all of the above
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
1 - hepatitis A vaccine
3 - influenza vaccine (annual)
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?
- Jaundice and fatigue
- Sex with a sex worked as hepatitis B can be transmitted sexually
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?
- ALT (alanine transaminase): 1250 U/L (normal range: 0-50)
- Total Bilirubin: 82 umol/L (normal range: 0-22)
- Ultrasound abdomen: mild hepatomegaly
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?
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
Can patients with hepatitis B breastfeed?
- yes
