Infective Hepatitis Flashcards
What is hepatitis?
- inflammation of the hepatocytes along the portal tracts
- on histology presents lobular or periportal (close to portal vein)
How does inflammation present on histology around the cholangiocytes?
- around the bile duct
In the images below, which is inflammation of the hepatocytes (presents as lobular or periportal inflammation) and which is inflammation of the cholangiocytes (epithelial cells of bilary tree) which presents around the bile duct?
- A = hepatocytes
- B = cholangiocytes
What are some common causes of hepatitis?
- drugs such as paracetamol
- alcohol
- viruses
- autoimmune disease.
What are some common clinical presentations of hepatitis?
- nausea, vomiting, fevers, joint pain and muscle aches, jaundice, abdominal pain, itchy skin, pale stools and dark urine
Patients with hepatitis can present with pale stools, why is this?
- bile may not be secreted
- ultimatley stercobilin not in GIT so no dark stool colour
Patients with hepatitis can present with dark urine, why is this?
- bile re-absorbed
- high levels of stercobilin reabsorbed and enters circulation
- makes its way to kidneys
What is the difference between acite and chronic hepatitis?
- chronic means inflammation perseveres
- inflammation leads to scarring, fibrosis and cirrhosis
What common drug can cause acute hepatitis?
- paracetamol
What virus can cause acute hepatitis?
- hepatitis A and E
- spread in food and dirty water in travellers
- A+E are vowels so its in the bowels
What virus can cause chronic hepatitis?
- hepatits B and C
- transmitted through bodily fluids and circulation
- generally spread by blood-to-blood contact associated with injection drug use, poorly sterilized medical equipment, needlestick injuries in healthcare, and transfusions
In addition to hepatitis C, what other condition can cause chronic hepatitis?
- autoimmune hepatitis
What viruses can cause both chronic and acute hepatitis?
- hepatitis B and E
If the ALT is really high but other liver enzymes are not affected, what can this be indicitive of?
- hepatitis consistent with acute viral causes or paracetamol
What 3 liver conditions do not tend to cause an increase in liver enzymes?
1 - alcohol
2 - NAFLD
3 - autoimmune hepatitis
At what stage of hepatitis can be reversed?
- before it becomes fibrotic
- stimulus for damage must be stopped
Where is hepatitis A prevelent?
- developing countries
- south east asia
What type of virus is hepatitis A?
- picornavirus
- single stand of RNA surrounded by capsid
- no lipid membrane
How many people a year are affected by hepatitis A and how is it spread?
- 3 million people worldwide
- faecal oral route, contaminated water and food
Does hepatitis A cause symptoms dstraigh away or is the an incubation period?
- incubation of between 2-6 weeks
How is hepatitis A diagnosed?
- B cells secrete IgM anti-HAV in serum detected in the blood
- HAV = hepatitis A virus