Viral hepatitis Flashcards
What is hepatitis?
Inflammation of the liver
How many types of viral hepatitis are there?
5
What would the liver function tests for a ‘hepatic picture’ show?
A hepatic picture on liver function tests refers to high transaminases (AST and ALT) with proportionally less of a rise in ALP. Bilirubin can also rise due to the inflammation of the liver cells.
What are transaminases?
Liver enzymes released into the blood due to inflammation of the liver cells.
What hepatitises are transmitted via the fecal-oral route?
Hep A and B
What hepatitis’s transmitted by only blood?
hepatitis c
What hepatitis’s transmitted by blood and bodily fluids?
hep b
What kind of hep B infection would the patient have if they were positive for Hep B core IgM?
acute infection
What kind of infection for hep b would it indicate if you had HBcAb and HBsAb?
You have had the infection and got rid of it completely
What kind of infection would it suggest if you had only the HBsAb?
Immunization to hep B, implied resolution of HBV infection if other markers were negative.
What kind of infection would it suggest if you had had the HBsAg and HBsAb?
It would suggest a chronic infection
Why would you test for HBV DNA?
To determine the infectivity of an individual
Why are HBe Ag and HBeAb measured?
They are markers of infectivity. People with the antigen are more infective than those with the antibody
What are the pharmacological options for hep B?
Antiviral medication can be used to slow the progression of the disease
What is the treatment cure for hepatitis C?
Direct-acting antiviral medications, eg sofosbuvir and daclatasvir
Why is hepatitis C RNA testing done?
To confirm the diagnosis of hepatitis C, calculate the viral load and identify the genotype?
What is autoimmune hepatitis?
A rare cause of chronic hepatitis, it appears to occur due to a combination of genetic and environmental factors.
When does type 1 autoimmune hepatitis usually present?
Type 1 typically affects women in their late forties or fifties. It presents around or after menopause with fatigue and features of liver disease on examination. It takes a less acute course than type 2.
When does type 2 autoimmune hepatitis usually present?
Type 2 usually affects children or young people, more commonly girls. It presents with acute hepatitis with high transaminases and jaundice.
How would the LFT blood test in autoimmune hepatitis usually present?
Investigations will show high transaminases (ALT and AST) and minimal change in ALP levels (a “hepatitic” picture). Raised immunoglobulin G (IgG) levels are an important finding. Also raised autoantibodies.
What are the autoantibodies in type 1 autoimmune hepatitis?
Anti-nuclear antibodies (ANA)
Anti-smooth muscle antibodies (anti-actin)
Anti-soluble liver antigen (anti-SLA/LP)
What are the autoantibodies in type 2 autoimmune hepatitis?
Anti-liver kidney microsomes-1 (anti-LKM1)
Anti-liver cytosol antigen type 1 (anti-LC1)
What would the biopsy finding be for autoimmune hepatitis?
Key histology findings are interface hepatitis and plasma cell infiltration.
