Viral Hepatitis Flashcards
1
Q
What are the different causes of hepatitis?
A
- infection (CMV/EBV)
- drugs (alcohol, paracetamol overdose, co-amoxiclav)
- autoimmune
- ischaemic
2
Q
List the functions of the liver
A
- synthesise clotting factors
- conjugate bilirubin
- metabolise carbohydrates
- produce compliment factors
- metabolise drugs, hormones and toxins
- synthesise albumin
- produce bile salts
3
Q
What are the symptoms of hepatitis?
A
- asymptomatic
- fever
- jaundice
- malaise
- diarrhoea/vomiting
- acute liver failure (bruising/ascites/encephalopathy)
4
Q
What are the consequences of hepatitis?
A
- cirrhosis (fibrosis/scarring)
- liver cancer (hepatocellular carcinoma - esp with Hep B/C)
5
Q
What are the main ways Hep A is spread and how it presents?
A
- shellfish or contaminated water
Presentation:
- hepatomegaly
- jaundice
- fatigue
- joint pain
- poor appetite
6
Q
How would you test Hep A infections?
A
- Hep A IGM = acute infection (if IgG = immunity)
7
Q
What are some ways of transmitting Hep B, C and D, and its presentation?
A
- unprotected sex or contaminated needles
Presentation:
- asymptomatic
- jaundice
- poor appetite
- sore muscles
- fever
- tender hepatomegaly
8
Q
How would you test for Hep B?
A
- HbsAg/HBeAg/Anti HBc IgM (= acute infection)
- Anti HBc IgG (= chronic infection)
- Anti HBs (previous infection/vaccine)
9
Q
How would you treat Hep B?
A
- no cure, suppress viral replication
- entecavir, tenofovir (inhibit RNA polymerase)
- pegylated interferon alpha (stimulate activation of genes involved in immunity)
10
Q
Describe the investigations for Hep C?
A
- look for Hep C RNA (= active infection)
- anti-Hep C antibody (= recovery/chronic infection)
11
Q
What is unique about Hep B?
A
- its severity is based on the host’s immune response
- its complications are due to host T cell activity
- the better the immune response the more damage to hepatocytes
- very high risk of developing hepatocellular carcinoma
12
Q
What is unique about Hep C?
A
- most common cause of chronic viral hepatitis
13
Q
What are some extrahepatic manifestations of chronic Hep C?
A
- autoimmune: thyroid disease
- haematological: lymphoma
- pulmonary: fibrosis
- renal: membranous proliferative glomerulonephritis
- skin: lichen planus, porphyria cunea tardia
14
Q
What is the treatment for Hep C?
A
- direct acting antivirals (12-24 weeks)
- paritaprevir (protease inhibitor)
- ledipasvir (NS5A inhibitor)
- sofosbuvir (RNA polymerase inhibitor)
15
Q
What is unique about Hep D?
A
- only possible if you already have Hep B (presents the same)
- presents most severe form of hepatitis due to rapid progression of disease and development of hepatocellular carcinoma
