L15 blood borne virsuses

Question 1

Which disease is most common out of HIV, Hep B and Hep C?

Answer 1

Hep C (most are untested)

Question 2

What does hepatitis literally mean?

Answer 2

inflammation of the liver

Question 3

what are the three elements of the portal triad?

Answer 3

hepatic artery, bile duct, portal vein

Question 4

how is bilirubin formed?

Answer 4

This is the end product of haemoglobin metabolism, it bound with albumin moves from the spleen into the liver to form a component of bile, it is then excreted in the faeces mainly and some urine

Question 5

jaundice is the yellowing of the skin and sclera due to deposits of bilirubin in the body due to its excess, cause scan be intrahepatic or extrahepatic. Give one example of each

Answer 5

Intrahepatic - Problems conjugating the bilirubin into bile often due to fibrosis of the liver from drinking etc.

Extrahepatic - Blockage in the bile or pancreatic duct often the result of gallstones

Question 6

what are the risks of transmission following a needlestick injury in the following diseases?:

• HIV
• Hep C
• Hep B

Answer 6

• HIV - 1/300
• Hep C - 1/30
• Hep B - 1/3 - much lower if recipient has been vaccinated

Question 7

post exposure prohpylaxis is useful in HIV and Hep B needlestick injuries, what does this entail?

Answer 7

-Give ARV’s within 72 hours max but ASAP,

not prophylaxis but also:
- bleed and wash wound, collect blood from patient and exposed HCA, inform occupational health , check Hep B vaccination status

Question 8

see important microbes document for most of lecture - hepatitis

Answer 8

yes

Question 9

Which hepatitis viruses are chronic illnesses ?

Answer 9

Hep B and Hep C

Question 10

Heptatitis A and C are ____ viruses, whilst hepatitis B is a ______ virus

Answer 10

RNA

DNA

Question 11

Signs and symptoms of hepatitis are indicative or reduced liver function as hepatitis involves destruction of hepatocytes. T/F?

Answer 11

T

Question 12

Raised ALT indicateswhat?

Raised ALP indicates what

Answer 12

ALT - liver problem

ALP - extrahepatic damage

Question 13

Raised ALT indicateswhat?

Raised ALP indicates what

Answer 13

ALT - liver problem

ALP - extrahepatic damage

Question 14

What are some investigations that would be carried out if you suspected hepatitis?

Answer 14

LFT’s - ALT will be raised (problems in liver)/ALP may also be raised/coagulation will be low so Prothrombin time and INR will be low as the clotting factors are synthesised in the liver.

Question 15

What are some investigations that would be carried out if you suspected hepatitis?

Answer 15

LFT’s - ALT will be raised (problems in liver)/ALP may also be

raised/coagulation will be low so Prothrombin time and INR will be low as the clotting factors are synthesised in the liver

FBC - potentially anaemia /high bilirubin

Hep B/C serology
(anti-Hep B/C)

Question 16

What is the major cause of Hep B and what is the major cause of Hep C (note some other causes too)

Answer 16

Hep B - vertical transmission
Hep C - IV drug use

Other causes - needlestick injuries/sexual contact/significant blood exposure

Question 17

What is the treatment for Hep B and Hep C?

Answer 17

Hep B - Lifelong anti-virals. Incurable

Hep C - Antiviral drug combo - very expensive but good success rate

Question 18

What are the main complications of chronic Hep B infection?

Answer 18

Liver cancer and cirrhosis

Question 19

What are the main complications of chronic hep C

Answer 19

Liver disease/ liver cancer/death

Question 20

There is a vaccination against Hep B available which involves giving the surface antibody (HbsAb) what are the other two involved.? (look at this slide)

Answer 20

Surface antigen (HbsAg)
Core antibody (HbcAb)