Hepatology

Question 1

HAV

• Transmission
• Pt group
• Vaccine?

Answer 1

• Oral-faecal
• Travel, poor sanitation, 40% of acute viral (MSM)
• There is a vaccine

Question 2

HBV

• Transmission
• Pt group
• Vaccine?

Answer 2

• Parenteral, vertical, sexual
• IVDU, unprotected sex, HIV
• There is a vaccine

Question 3

HCV

• Transmission
• Pt group
• Vaccine?

Answer 3

• Parenteral, vertical, sexual
• IVDU, MSM
• NO VACCINE

Question 4

HDV

• Transmission
• Pt group
• Vaccine?

Answer 4

• Parenteral, sexual - BUT only in presence of active HBV
• HBV patients
• NO VACCINE

Question 5

HEV

• Transmission
• Pt group
• Vaccine?

Answer 5

• Oral-faecal
• Developing world, travellers, outbreaks
• There is a vaccine
  NB - high mortality in pregnancy

Question 6

Treatment for all Hepatitis?

Answer 6

PegInterferon for Hep B,C,D
\+Tenofovir for HepB
\+ Ribavirin for HepC
Nothing for acute Hep A or E
Ribavirin for Hep E chronic

Question 7

What drug is common anti-emetic?

Answer 7

Metoclopramide

Question 8

LFTs in Acute Hepatitis?

Answer 8

Highly raised ALT & AST (>1000)
Raised Bilirubin (>500)

Question 9

LFTs in chronic Hepatitis?

Answer 9

ALT & AST midly raised (<100)

Question 10

Clinical diagnosis of Gilberts syndrome made on what symptoms?

Answer 10

(Single) episode of mild jaundice ASSOCIATED WITH:

physical exertion; fasting; surgery; illness; alcohol

Question 11

Which Hep treatment is teratogenic?

Answer 11

Ribavarin…which is given to chronic HEV infection, which has a high mortality in pregnancy…so be careful of this one!

Question 12

HBV Serology:

HBsAg +ve

Answer 12

Active HBV

Question 13

HBV Serology:
HBsAg -ve
HBcAb +ve

Answer 13

No active HBV, prior exposure with clearance

Question 14

HBV Serology:
HBsAg -ve
HBcAb +ve
HBsAb +ve (high level)

Answer 14

Previous exposure with clearance and good immunity