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Alimentary System: Pathology SA > Liver Symposium - Viruses > Flashcards

Liver Symposium - Viruses Flashcards

1
Q

What are the 5 main viruses affect the liver

A

Hepatitis:

A,B,C,D

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2
Q

What Hepatitis viruses are enteric (Viruses that take the faecal-oral route)

A

Hepatitis A, E

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3
Q

What Hepatitis viruses are Parenteral viruses - occur outside alimentary canal

A

Hepatits B,C,D

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4
Q

What type od hepatits infection results in self limiting acute infections and chronic disease

A

Acute - Hep. A,E

Chronic- Hep B,C,D

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5
Q

What is the clinical course of Hepatitis A

in regard to antibodies

A

Vireamia presents and IgM antibodies increase

People initially feel unwell experiencing flu like symptoms

IgG antibodies increase above IgM around 8 weeks and clinical illness begins to disappear

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6
Q

When does Hepatitis A occur

A

Sporadically

or an epidemic

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7
Q

How is Hepatitis A transmitted

A

Faecal -oral route

Sexual

Blood

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8
Q

What is a very common case for hepatitis A infection

A

Patient can present asymptomatic

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9
Q

What is the demographic of Hepatitis A

A

Age - common 5-14 Years

Countries -

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10
Q

Who are vaccinated against hepatitis A

A

Travellers

Patients with chronic liver disease

Haemophiliacs

Occupational exposure

Men who have sex with men (MSM)

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11
Q

What is the structure of Hepatitis B

A

There is a inner protein core containing genetic material and is surrounded by outer lipid envelop that has a surface antigen

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12
Q

What is the antigen present in the protein core of hepatitis B that is not detected in the blood

A

Hepatits B c antigen

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13
Q

What antigen is released from the core of the hepatitis B virus and can be detected in the blood

A

Hepatitis B e antigen

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14
Q

What is the surface antigen present on the Hepatitis B virus

what does this indicate

A

Hepatitis B s Antigen

Indicating that the virus is present

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15
Q

What antigens present from Hepatitis B indicated active replication is occurring

A

Hepatits B c/e antigen

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16
Q

What antibody is present when hep B first appears,

How long does it take to clear

A

IgM

6 months

17
Q

What antibody In hepatitis B when the infection becomes chronic

A

IgG

Chronic > 6months

18
Q

What antibody presence shows that the hepatitis B infection is now inactive

A

Antibody Hepatitis B e

19
Q

What dies the presence of antibody HB s indicate in a hepatic B infection

A

The presence of anti-HBs is generally interpreted as indicating recovery and immunity from hepatitis B virus infection

20
Q

So what are the overall steps in diagnosis Hepatitis B infection

A

Is Hepatits B antigen present?

Is there
Clinical evidence of infection

If no = chronic infection

If yes –> Test for IgM

If Igm is positive = acute infection

If IgM infection negative = Chronic infection

21
Q

What is the pathology of chronic hepatitis B if further progression occurs

A

Liver Cirrhosis

which Further leads to Liver cancer and end stage liver disease

22
Q

What is the treatment options for Hepatitis B

A

Pegylated Interferon

Oral antiviral drugs

23
Q

What are examples of Oral antiviral drugs used to treat Hep B

A

Entecavir
Adenofovir
Lamivudine, telbivudine, Tenofovir

24
Q

What is Pegylated interferon

A

3 drug therapy of
alpha 2a, alpha 2b, beta 1a

targeting intracellular signalling

25
Q

Hepatitis C is mostly asymptomatic till what progression occurs

A

Liver cirrhosis

- have normal liver function tests

26
Q

What is the natural history and pathology of hepatis C infection

A 
Exposure 
Resolved - 15% 
Chronic - 85%
Cirrhosis - 20%
Liver cancer - 25%
27
Q

What further intervention occurs with an hepatitis C infection to result in Liver caner

A

HIV infection and alcohol

28
Q

What is the percentage of people that present with acute jaundice due to hepatitis C

A

10%

29
Q

What is the structure of Hepatitis C

A

Genetic material located at the core of virus, surrounded by a protective shell of protein encased in a lipid envelope with 2 glycoprotein embedded in envelope

30
Q

When do you know recovery is happening in hepatitis C

A

When Hepeptisi C RNA decreases

ALT tests decrease

When there is an increased presence of antibody hepatic C

31
Q

What does ALT test for

A

Liver damage

32
Q

What is the treatment plan for hepatitis C

A

IFN free combination of direct acting antiviral drugs
e.g ledipasvir, simeprevir, sofosbuvir

giver for 3 months

33
Q

What is the structure of Hepatitis D

A

Smalll RNA virus

doesn’t have protein coat

34
Q

How does Hepatitis D envelope itself

A

Envelopes itself with hebatits B antigen in a co-infection/superinfection

35
Q

What affect does treatment have on hepatitis D

A

very resistant

36
Q

What is the biggest source of infection is Hepatitis D

A

Pigs eg infected pork meat

37
Q

What hepatitis virus is the commonest cause of acute hepatitis in NHS grampian

A

Hep E

38
Q

What is the treatment for Hep E

A

Non specific and there is a vaccine yet

self limiting g- resolves itself without medicine

39
Q

What are other viruses causing potentially damage to the liver

A 
Hepatitis F		Hepatitis G			
Hepatitis GB
EBV	
CMV			
Herpes simplex

Alimentary System: Pathology SA (27 decks)

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