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Gastroenterology > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

Which is the only DNA type viral hepatitis?

A

Hep B

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2
Q

Which viral hepatitis are transmitted by faecal oral route?

A

A and E

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3
Q

What is the transmission of hep A?

A

Faecal oral

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4
Q

What is the transmission of hep B?

A

Blood/bodily fluids

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5
Q

What is the transmission of hep C?

A

Blood

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6
Q

What is the transmission of hep D?

A

Always with hep B

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7
Q

What is the transmission of hep E?

A

Faecal oral

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8
Q

Which viral hepatitis have a vaccine?

A

A and B

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9
Q

What is the main treatment for hep A?

A

Supportive

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10
Q

What is the main treatment for hep B?

A

Supportive / antivirals

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11
Q

What is the main treatment for hep C?

A

Direct acting antivirals

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12
Q

What is the main treatment for hep D?

A

Pegylated interferon alpha

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13
Q

What is the main treatment for hep E?

A

Supportive

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14
Q

Which of the viral hepatitis infections are notifiable diseases?

A

All

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15
Q

What are 4 other causes of hepatitis aside from viral?

A

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

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16
Q

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

A

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

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17
Q

What do LFTs show in viral hepatitis?

A

High transaminases
High bilirubin

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18
Q

What is the most common viral hep worldwide?

A

A

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19
Q

What type of virus is hep A?

A

RNA

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20
Q

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

A

Cholestasis
Pruritis
Jaundice
Dark urine
Pale stools

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21
Q

How is hep A diagnosed?

A

Based on IgM antibodies to help A

22
Q

What is a rare side effect of hep A?

A

Acute liver failure (fulminant hepatitis)

23
Q

What type of virus is hep B?

A

Double stranded dna

24
Q

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

A

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

25
Q

How do you become a chronic hep B carrier?

A

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

26
Q

What is HBsAg and what does it indicate?

A

Surface antigen
Active infection

27
Q

What is HBeAg and what does it indicate?

A

E antigen
Marker of viral replication and indicates high ingectivity

28
Q

What is HBcAb and what does it indicate?

A

Core antibodies
Implies past or current infection

29
Q

What is HBsAb and what does it indicate?

A

Surface antibody
Implies vaccination or past or current infection

30
Q

What is HBV DNA and what does it indicate?

A

Hep B virus dna
A direct count of the viral load

31
Q

What do you test for to screen for hep b?

A

HBcAb for previous infection
HBsAg for active infection

32
Q

What is given in the hep b vaccine?

A

HBsAg surface antigen

33
Q

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

A

HBsAb
Surface antibody

34
Q

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

A

Using HBcAb

IgM implies active infection
High titre IgM = acute infection
Low titre IgM = chronic infection

IgG implies past infection

35
Q

How many doses of the hep b vaccine are needed?

A

3

36
Q

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

A

Active acute infection of hep b

37
Q

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

A

Active chronic infection

38
Q

Person has IgG HBcAb. What does this indicate?

A

Past infection

39
Q

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

A

○ 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)

40
Q

What type of virus is hep c?

A

RNA

41
Q

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

A

Sofosbuvir
Daclatasvir

42
Q

What are some complications of hep c? (2)

A

○ Liver cirrhosis and associated complications of cirrhosis
Hepatocellular carcinoma

43
Q

What is the screening test for hep c?

A

Hep c antibody

44
Q

What is hep c rna testing for?

A

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

45
Q

What is used to confirm diagnosis of hep c?

A

Hep c rna testing

46
Q

What is the duration of treatment for hep c?

A

8-12 weeks

47
Q

What type of virus is hep d?

A

RNA

48
Q

How does hep d survive in the human body?

A

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.

49
Q

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

A

Hep d

50
Q

How long is the treatment of hep d?

A

At least 48 weeks

51
Q

What type of virus is hep e?

A

RNA

52
Q

What are the complications of hep e?

A

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

Gastroenterology (31 decks)

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