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Infection A > Session 8 Lecture 2 > Flashcards

Session 8 Lecture 2 Flashcards

1
Q

Define hepatitis

A

Inflammation of the liver

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2
Q

Which systemic viruses cause ‘collateral’ liver damage?

A

EBV, CMV, VZV

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3
Q

Where do hepatitis viruses replicate?

A

Replication specifically in hepatocytes

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4
Q

What are the most common type of hepatitis?

A

B and C

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5
Q

Which hepatitis cause chronic infection?

A

B and C

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6
Q

What causes jaundice?

A

The build up of bilirubin attaches the skin and the sclera

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7
Q

What is bilirubin?

A

The breakdown of haem

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8
Q

What are the different types of jaundice?

A

Prehepatic, intrahepatic and post hepatic.

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9
Q

What causes prehepatic jaundice

A

Haemolysis, sickle cell anaemia or haemolytic anaemia

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10
Q

What is intrahepatic jaundice?

A

Disruption happens inside the liver

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11
Q

What are the causes of intrahepatic jaundice?

A

Viral hepatitis, drugs, aprganncy, cirrhosis

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12
Q

What is post hepatic jaundice?

A

Disruption prevents the bile (and the bilirubin) from draining out of the gallbladder and into the digestive system

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13
Q

What causes post hepatic jaundice?

A

Duct stones, carcinoma of bile duct, biliary stricture

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14
Q

What is the purpose of liver function tests?

A

They tell you the cellular integrity - not how the liver is functioning

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15
Q

What are measured in liver function tests?

A

Bilirubin, liver transaminase, alkaline phosphate, albumin and tests for coagulation

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16
Q

What do liver transaminases show?

A

Hepatocytes damage/cellular integrity

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17
Q

What do alkaline phosphatase (ALP) show?

A

Biliary tract cell damage/cholestasis

18
Q

Why do you do test of coagulation when testing the liver function?

A

Clotting factors are synthesised in the liver

19
Q

Who is at risk of hepatitis B?

A

Vertical transmission (75% of cases globally)
Sexual contact
IV drug users

20
Q

What are the symptoms of acute hep B?

A

Jaundice, fatigue, abdominal pain, anorexia/vomiting/nausea and arthralgia

21
Q

What is the incubation period of hep B?

A

6wks to 6 months

22
Q

What happens if you acquire Hep B in childhood?

A

You are more likely to get chronic infection

23
Q

What are antigens are detectable in Hep B serology?

A

HBsAg, HBeAg and HBcAg

24
Q

What antibodies are detected in hep B serology?

A

HBsAb, HBeAb, HBcAb - IgM and IgG

25
Q

What is the definition of chronic Hep B infection?

A

Persistence of HBsAg after 6 months.

26
Q

What does chronic Hep B lead to?

A

25% of chronic infections lead to cirrhosis and 5% will develop hepatocellular carcinoma

27
Q

What is the treatment for Hep B?

A

No cure

Life long anti-virals to suppress viral replication

28
Q

Why is there no cure for Hep B?

A

Virus integrates into host genome

29
Q

Why are life long antivirals not needed by everyone who has Hep B?

A

Some people are inactive carriers - low VL, normal LFTs and no liver damage

30
Q

What does the hep B vaccination contain?

A

Genetically engineered surface antigen . 3 doses + boosters if required. Effective in most people

31
Q

Who is at risk of hepatitis C?

A

IV drug user
Sexual contact
Infants

32
Q

Describe the disease progression of Hep C?

A

~80% become chronically infected. Of these, some will develop chronic liver disease/cirrhosis.

33
Q

What percentage of people with Hep C suffer from symptoms?

A

80% have no symptoms (acute or chronic)

20% have symptoms

34
Q

What are the symptoms of Hep C?

A

Fatigue, anorexia, nausea and abdominal pain

35
Q

What blood tests can be done for Hep C?

A

Serology - anti-hep C antibody only

Viral PCR - if positive confirms on-going/chronic infection

36
Q

Can hep C be cured?

A

Yes

37
Q

What is the treatment for Hep C?

A

Directly acting antiviral drug combo

8-12 weeks

38
Q

Is there a vaccine available for hep C?

A

No

39
Q

What is the risk of transmission from a needle stick injury with HIV?

A

1/300

40
Q

What is the risk of transmission from needle stick injury with Hep C?

A

1/30

41
Q

What is the risk of transmission from needle stick injury with Hep B?

A

1/3 - much lower if the recipient has been vaccinated

Infection A (18 decks)

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