Session 8-Blood Borne Viruses:Hep

Question 1

What is hepatitis?

Answer 1

Inflammation of the liver

Question 2

What is cholestatic jaundice?

Answer 2

Bile is static, isn’t moving

Question 3

What is intrahepatic jaundice?

Answer 3

Problem with hepatocytes

Question 4

What is extrahepatic jaundice?

Answer 4

Obstruction of bile flow

Question 5

True or false: alanine transaminase (ALT) is more sensitive than aspartate aminotransferase (AST)

Answer 5

TRUE

Question 6

What are the tests of coagulation?

Answer 6

• INR (international normalised ratio)

- Prothrombin time (PT)

Question 7

What does an elevated ALT level indicate?

Answer 7

Problem lies within hepatocytes -> intrahepatic jaundice

Question 8

What does an elevated alkaline phosphatase (ALP) test indicate?

Answer 8

Problem with bile flow so extrahepatic jaundice

Question 9

Who is at risk of contracting Hep B?

Answer 9

• sexual contact
• people who inject drugs
• close household contacts
• health care workers via needle stick injuries

Question 10

What are the symptoms of acute Hep B?

Answer 10

• jaundice
• fatigue
• abdominal pain
• anorexia/nausea/vomiting
• arthralgia (pain in joint)

Question 11

Describe the sequence of antigens and antibodies in a Hep B infection

Answer 11

1) HBsAg (surface antigen)
2) HBeAg (e-antigen) - highly infectious
3) HBcAb (core antibody) - IgM is the first antibody to appear
4) HBeAb (e-antibody)
5) HBsAb (surface antibody) - clearance of virus
6) HBcAb - IgG

Question 12

What is the definition of chronic Hep B infection?

Answer 12

Persistence of HBsAg after 6 months

Question 13

How can Hep B be treated?

Answer 13

Life-long anti-vitals to suppress viral replication

Question 14

Describe the Hep B vaccination

Answer 14

Genetically engineered surface antigen
3 doses and boosters if needed
Produces surface antibody response

Question 15

Who is at risk of contracting Hep C?

Answer 15

• intravenous drug users
• sexual contact
• infants born to HCV positive mothers
• blood transfusion before 1991
• needlestick injuries to health care workers etc

Question 16

What % of patients with Hep C become chronically infected?

Answer 16

~80%

Question 17

Some patients who become chronically infected with Hep C develop chronic liver disease. What does this result in?

Answer 17

• decompensated liver disease
• hepatocellular carcinoma
• transplant
• death

Question 18

What % of patients with Hep C have vague symptoms and what are these symptoms?

Answer 18

~20%

• fatigue
• anorexia
• nausea
• abdominal pain

Question 19

Describe the serology of Hep C

Answer 19

Anti-Hep C antibody only

Question 20

True or false: Hep B can be cured

Answer 20

FALSE - Hep C can be, Hep B cannot

Question 21

How can Hep C be treated?

Answer 21

Directly acting antiviral drug combo for 8-12 weeks