Viral Hepatitis

Question 1

Which is the only DNA type viral hepatitis?

Answer 1

Hep B

Question 2

Which viral hepatitis are transmitted by faecal oral route?

Answer 2

A and E

Question 3

What is the transmission of hep A?

Answer 3

Faecal oral

Question 4

What is the transmission of hep B?

Answer 4

Blood/bodily fluids

Question 5

What is the transmission of hep C?

Answer 5

Blood

Question 6

What is the transmission of hep D?

Answer 6

Always with hep B

Question 7

What is the transmission of hep E?

Answer 7

Faecal oral

Question 8

Which viral hepatitis have a vaccine?

Answer 8

A and B

Question 9

What is the main treatment for hep A?

Answer 9

Supportive

Question 10

What is the main treatment for hep B?

Answer 10

Supportive / antivirals

Question 11

What is the main treatment for hep C?

Answer 11

Direct acting antivirals

Question 12

What is the main treatment for hep D?

Answer 12

Pegylated interferon alpha

Question 13

What is the main treatment for hep E?

Answer 13

Supportive

Question 14

Which of the viral hepatitis infections are notifiable diseases?

Answer 14

All

Question 15

What are 4 other causes of hepatitis aside from viral?

Answer 15

• Alcoholic hepatitis
• Non-alcoholic steatohepatitis (NASH)
• Autoimmune hepatitis
• Drug induced hepatitis (e.g. paracetamol overdose)

Question 16

What are some non-specific symptoms of viral hepatitis? (7)

Answer 16

• Abdominal pain
• Fatigue
• Flu-like illness
• Pruritus (itching)
• Muscle and joint aches
• Nausea and vomiting
• Jaundice

Question 17

What do LFTs show in viral hepatitis?

Answer 17

High transaminases
High bilirubin

Question 18

What is the most common viral hep worldwide?

Answer 18

A

Question 19

What type of virus is hep A?

Answer 19

RNA

Question 20

What can hep A cause?
What symptoms does this lead to? (4)

Answer 20

Cholestasis
Pruritis
Jaundice
Dark urine
Pale stools

Question 21

How is hep A diagnosed?

Answer 21

Based on IgM antibodies to help A

Question 22

What is a rare side effect of hep A?

Answer 22

Acute liver failure (fulminant hepatitis)

Question 23

What type of virus is hep B?

Answer 23

Double stranded dna

Question 24

What are some modes of hep b transmission? (6)

Answer 24

Sex
Sharing needles
Sharing toothbrush
Sharing razors
Contact with open wounds
Vertical transmission from mother to child

Question 25

How do you become a chronic hep B carrier?

Answer 25

the virus DNA has integrated into the cell nucleus. They continue to produce viral proteins.

Question 26

What is HBsAg and what does it indicate?

Answer 26

Surface antigen Active infection

Question 27

What is HBeAg and what does it indicate?

Answer 27

E antigen Marker of viral replication and indicates high ingectivity

Question 28

What is HBcAb and what does it indicate?

Answer 28

Core antibodies Implies past or current infection

Question 29

What is HBsAb and what does it indicate?

Answer 29

Surface antibody Implies vaccination or past or current infection

Question 30

What is HBV DNA and what does it indicate?

Answer 30

Hep B virus dna A direct count of the viral load

Question 31

What do you test for to screen for hep b?

Answer 31

HBcAb for previous infection HBsAg for active infection

Question 32

What is given in the hep b vaccine?

Answer 32

HBsAg surface antigen

Question 33

What hep investigation will be positive if a person has been vaccinated?

Answer 33

HBsAb Surface antibody

Question 34

How do you distinguish between acute, chronic and past infections from hep investigations?

Answer 34

Using HBcAb IgM implies active infection High titre IgM = acute infection Low titre IgM = chronic infection IgG implies past infection

Question 35

How many doses of the hep b vaccine are needed?

Answer 35

3

Question 36

Person has high titre IgM HBcAb. What does this indicate?

Answer 36

Active acute infection of hep b

Question 37

Person has low titre IgM HBcAb. What does this indicate?

Answer 37

Active chronic infection

Question 38

Person has IgG HBcAb. What does this indicate?

Answer 38

Past infection

Question 39

What is included in the management of hep b? (9)

Answer 39

○ A low threshold for screening patients at risk of hepatitis B ○ Screen for other viral infections (e.g., HIV, hepatitis A, C and D) ○ Referral to gastroenterology, hepatology or infectious diseases for specialist management ○ Avoid alcohol ○ Education about reducing transmission ○ Contact tracing and informing potential at-risk contacts ○ Testing for complications (e.g., FibroScan for cirrhosis and ultrasound for hepatocellular carcinoma) ○ Antiviral medication can be used to slow the progression of the disease and reduce infectivity ○ Liver transplantation for liver failure (fulminant hepatitis)

Question 40

What type of virus is hep c?

Answer 40

RNA

Question 41

What are some direct acting antivirals used in hepatitis treatment? (2)

Answer 41

Sofosbuvir Daclatasvir

Question 42

What are some complications of hep c? (2)

Answer 42

○ Liver cirrhosis and associated complications of cirrhosis Hepatocellular carcinoma

Question 43

What is the screening test for hep c?

Answer 43

Hep c antibody

Question 44

What is hep c rna testing for?

Answer 44

used to confirm the diagnosis of hepatitis C, calculate the viral load and identify the genotype

Question 45

What is used to confirm diagnosis of hep c?

Answer 45

Hep c rna testing

Question 46

What is the duration of treatment for hep c?

Answer 46

8-12 weeks

Question 47

What type of virus is hep d?

Answer 47

RNA

Question 48

How does hep d survive in the human body?

Answer 48

It can only survive in patients who also have a hepatitis B infection. It attaches itself to the HBsAg and cannot survive without this protein.

Question 49

What can increase the complications and disease severity of hep b?

Answer 49

Hep d

Question 50

How long is the treatment of hep d?

Answer 50

At least 48 weeks

Question 51

What type of virus is hep e?

Answer 51

RNA

Question 52

What are the complications of hep e?

Answer 52

Rarely it can progress to chronic hepatitis and liver failure, usually in immunocompromised patients.