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Infection > Lecture 8 - Hepatitis (Blood Borne Diseases) > Flashcards

Lecture 8 - Hepatitis (Blood Borne Diseases) Flashcards

1
Q

What is Hepatitis?

A

Inflammation

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2
Q

What are some systemic viruses that can cause liver damage?

A

EBV (Epstein barr virus Glandular fever)
CMV (Chicken pox)
VZV (Varicellar Zoster Virus chicken pox)

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3
Q

What are Hepatotropes and what does this mean?

A

Hepatitis viruses

They exclusively affect, target and replicate in hepatocytes

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4
Q

What are the hepatitis virus family?

A

Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Hepatitis E

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5
Q

How to remember the hepatitis family of viruses?

A

Hep A A for Acute
Hep C C for Chronic
Hep B B for between A and C
Hep D D for Double trouble Cant have D withou B
Hep E E is like A

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6
Q

How is Hepatitis A and Hepatitis E transmitted?

A

Faecal-oral route

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7
Q

Do you get symptoms with Hepatitis A and E?

A

Yes they are acute

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8
Q

How is Hepatitis C transmitted?

A

Blood MAINLY
(Very little through sex)

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9
Q

Does Hepatitis C cause symptoms?

A

No it is chronic

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10
Q

What do you die of if you get Hepatitis C?

A

Effects of :
-Liver cirrhosis
-hepatocellular carcinoma

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11
Q

How is Hepatitis B transmitted?

A

Blood
Sex
Vertical (mother to child)

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12
Q

With Hepatitis B you can get chronic illness or the illness can resolve itself, when are you likely to develop chronic illness and when is it likely to resolve?

A

Chronic = Infection as a child
Non chronic = infection as adult

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13
Q

How are both Hep B and Hep D transmitted?

A

Blood/sex/vertical

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14
Q

What is yellow tinging of the eyes called?

A

Jaundice

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15
Q

What tests are done when suspecting Hepatitis?

A

Bilirubin levels
Liver function Tests:
-Alanine Transaminase (ALT)
-Alkaline phosphatase (ALP)

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16
Q

What is the actual function of the liver?

A

Filters out bad stuff (toxins and metabolites) from the blood into the bile duct

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17
Q

Why are bilirubin levels high in Hepatitis?

A

Hepatocytes get overwhelmed by the virus being damaged or dead
Bilirubin from broken down RBCs not removed from blood

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18
Q

Why are AST/ALT levels high in Hepatitis?

A

AST and ALT released from dead and damaged hepatocytes (damaged by virus)

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19
Q

What causes the jaundice in Hepatitis?

A

High levels of bilirubin due to poor removal by liver hepatocytes

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19
Q

What causes the jaundice in Hepatitis?

A

High levels of bilirubin due to poor removal by liver hepatocytes

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20
Q

What are the 2 types of ways jaundice can generally happen?

A

Intra-hepatic
Extra-hepatic

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21
Q

What is meant by a Intra-hepatic cause of jaundice?

A

Liver overwhelmed so bilirubin not efficiently removed

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22
Q

What is meant by an Extra-hepatic cause of jaundice?

A

Blockage of the bile duct

23
Q

What does High levels of ALT/AST indicate?

A

Hepatocyte damage

24
Q

What does high levels of ALP (Alkaline Phosphatase) indicate?

A

Bile duct cell damage (Cholestasis)

25
Q

Why are albumin levels and tests of coagulation done if suspected hepatitis?

A

Albumin synthesised in live
Clotting factors made in liver

26
Q

What are the 3 main causes of high ALT?

A

Viral hepatitis
Drugs/medications (paracetamol/excess alcohol)
Blood clots

27
Q

Why is Hep B the most common Hepatitis infection?

A

It requires the lowest viral load to establish infection

28
Q

What is the most common method of transmission of Hep B?

A

Vertical transmission

29
Q

If somebody has acute Hepatitis B what are the usual vague symptoms?

A

Jaundice
Fatigue (is the pain of the liver)
Abdominal pain
Anorexia/nausea
Arthralgia

30
Q

What is arthralgia?

A

Pain in the joint

31
Q

What does HBsAg stand for?

A

Hepatitis B Surface Antigen

32
Q

What does HBeAg stand for?

A

Hepatitis B e-antigen

33
Q

What does HBsAb stand for?

A

Hepatitis B Surface Antibody

34
Q

What does HBcAb stand for?

A

Hepatitis B Core antibody

35
Q

What are the 2 types of HbcAb (Core antibody)?

A

IgM
IgG

36
Q

What is the role of IgM? (Core antibody)

A

Antibody that is first produced in response to acute Hepatitis

37
Q

What is the role of IgG? (Core antibody)

A

Antibody that persists in the blood for life

38
Q

In serology, what does a positive presence of surface antigen (HBsAg) indicate?

A

Hepatitis virus present

39
Q

What does the positive presence of Core antibody (HbcAb) indicate?

A

Someone has had the infection at some point

40
Q

What is the order of antibodies being released when infected by hepatitis?

A

Core antibody IgM
Surface antibody
Core antibody IgG

41
Q

What is the role of the surface antibody?

A

Clears the remainder of the virus
If not produced will get chronic hepatitis B infection

42
Q

What is the definition of CHRONIC Hepatitis B infection?

A

Persistence of HbsAg after 6 months

43
Q

At what point is Hepatitis not treatable?

A

Once the virus integrates its genetic material into the host genome

44
Q

How is Hep B treated if it has not integrated into the host genome?

A

Life long Anti-virals to suppress viral replication

45
Q

What are the principles for vaccinating against Hep B?

A

Genetically engineered surface antigen given to stimulate production of surface antibody

46
Q

If somebody has a past cleared infection, what is there status of:
Surface antigen (HbsAg)?
Core antibody (HbcAb)?
Surface antibody (HBsAb)?

A

HbsAg = Negative
HbcAb = Positive for IgG
HbsAb = Positive

47
Q

If somebody has a chronic infection, what is there status of:
Surface antigen (HbsAg)?
Core antibody (HbcAb)?
Surface antibody (HBsAb)?

A

HbsAg = Positive
HbcAb = Positive for IgG
HbsAb = Negative

48
Q

If somebody has a never infected but vaccinated, what is there status of:
Surface antigen (HbsAg)?
Core antibody (HbcAb)?
Surface antibody (HBsAb)?

A

HbsAg = Negative
HbcAb = Negative
HbsAb = Positive

49
Q

Who is most at risk of Hepatitis C?

A

Intravenous drug users (Inject drugs)

50
Q

How does someone with Hep C present?

A

Not normally any symptoms
Until liver cirrhosis or hep to cellular carcinoma

51
Q

If someone has symptoms from Hep C, what usually would they be?

A

Vague:

-Fatigue
-Anorexia
-Nausea
-Abdominal pain (RUQ)

52
Q

How do you test for Hep C?

A

Serology (Anti-Hep C antibody only)

Viral PCR

53
Q

How can Hep C be cured?

A

Antiviral drug combo

NO VACCINE THO

54
Q

In the context of HIV, what is PEP?

A

Post exposure prophylaxis
(Medication taken after exposure)

55
Q

If a medical student accidentally pricks themselves with a needle they used to get blood from a patient who is HbsAg positive, what might they do?

A

Receive Hep B booster

Infection (21 decks)

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