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Gastro > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

What is the main clinical maifestation of hepatitis viruses

A

Cause liver disease

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2
Q

Why has there been a decline of acute Hep A

A

Due to vaccination and better housing

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3
Q

Who is most commonly diagnosed with Hep B

A

Ethnic minorities who acquired Hep B mostly outside of the UK

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4
Q

What has caused the rise in Hep E in recent years

A

A mix of cases acquired outside the Uk and cases acquired within the UK

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5
Q

How is Hep A transmitted?

A

Faecal-oral

Poor hygiene / overcrowding

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6
Q

What are the common clinical presentations of Hep A

A

Usually asymptomatic

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7
Q

In what population is there a peak incidence of symptomatic disease

A

Older children / young adults

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8
Q

How is Hep A confirmed

A

Lab confirmation

Clotted blood for serology - yellow top bottle

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9
Q

How effective is the vaccine prophylaxis

A

Good - gives long term protection but needs 10 days to take effect

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10
Q

How is Hep A controlled?

A

Through good hygiene - infected food handlers are excluded from the workplace

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11
Q

Where is Hep E most common

A

In the tropics

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12
Q

What is more common in the UK Hep A or Hep E

A

Now Hep E

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13
Q

How is Hep E transmitted

A

Faecal-oral

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14
Q

What other animals can have Hep E

A

Pigs, deer, rabbits

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15
Q

How can some humans become infected with Hep E?

A

If they are immunocompromised

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16
Q

When is Hep D found

A

In association with Hep B

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17
Q

What is the effect of Hep D

A

It exacerbates Hep B

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18
Q

How is Hep B transmitted? (3 ways)

A

Sex
Mother to child
Blood (IV drug users)

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19
Q

What happens to the risk of chronic infection with increasing age at exposure

A

Decreases

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20
Q

What happens to the risk of acute hepatitis as age increases at exposure

A

Increases

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21
Q

Where is there a high prevalence of Hep B and why?

A

Canada, Alaska and Greenland

Due to their indigenous communities

22
Q

How is Hep B confirmed

A

Lab - surface antigen (HBsAg) present in blood

23
Q

What is also likely to be present in recently infected cases

A

Hep B IgM

24
Q

How can we acquire immunity of Hep B

A

Vaccine or past infection

25
Q

Describe the relationship between an indivual chronically infected with their infection

A

Dynamic - constantly changing - 1 treatment may not be applicable 1 day and would be the next

26
Q

How can we control the spread of Hep B

A 
Minimise exposure 
safe blood, 
safe sex
needle exchange
prevent needlestick injuries
Screening pregnant women
27
Q

What would happen to the baby if the mother was Hep B positive during pregnancy

A

Given a vaccine at birth to prevent mother to child transmission

28
Q

What are the two pre-exposure vaccination strategies

A

Vaccination of at risk people

Vaccination of all children / adolescents

29
Q

How is Hep C transmitted

A

Similar to Hep B
Mother to child
Blood
Less often through sex

30
Q

What are the precautions for Hep C

A 
Minimise exposure 
safe blood, 
safe sex
needle exchange
prevent needlestick injuries
Screening pregnant women
31
Q

How is hep C controlled

A

There is no vaccine

Minimise the exposure

32
Q

What defines chronicc

A

six months of infection

33
Q

What happens once there is a confirmed diagnosis for Hep C

A

Spontaneous cure is not seen

34
Q

What is the time it takes for the infection to cause cirrhosis

A

Typically more than 20 years

35
Q

How long does it typically take for Hepatitis C to cause heaptocellular carcinoma

A

More than 30 years

36
Q

What is the management of acute viral hepatitis

A

No antivirals
Monitor for encephalopathy
Monitor for resolution of Hep B, C or E if immunocompromised
Notify public health
immunisation of contacts
test for other infections if at risk
Vaccinate against other infections i at risk

37
Q

What is the management of chronic viral hepatitis

A 
Antibrials 
Vaccination
INfection control
Decrease alcohol consumption
Hepatocellular carcinoma awareness / screening
38
Q

What are the 2 most commonly used therapies in HBV?

A

Adefovir

Entecavir

39
Q

Who do we treat for viral hepatitis?

A

Chronic infection
Those at risk of complications
Those who are fit for treatment

40
Q

When is it best to treat viral hepatitis?

A

Before complications arise
When there is evidence of inflammation - advanced fibrosis
When the patient is ready
When it is a clinical priority

41
Q

What is interferon alfa

A

A human protein and part of the immune response to viral infection

42
Q

How is interferon alfa made

A

Through genetic engineering

43
Q

How is interferon alfa delivered

A

Given by injection

44
Q

What are 3 side effects of interferon alfa

A

Flu like symptoms
Autoimmune disease
Psychosis

45
Q

What are the 2 options for therapy of chronic hepatitis B

A

Peginterferon alone

Suppressive antiviral drug

46
Q

What are the advantages of using Peginterferon

A

Sustained cure possible from a few months of therapy

47
Q

What are the disadvantages of Peginterferon

A

Side effects
Injections
Only some benefit

48
Q

What are the advantages of Suppressive antiviral drugs

A

Safer

Larger range available

49
Q

What are the disadvantages of suppressive antiviral drugs

A

suppression not cure

resistance can develop

50
Q

What are some of the aims/ benefits of chronic hep B therapy

A 
Improved liver biochemistry 
Improved histopathology 
Reduced infectivity 
Reduced progression to cirrhosis and primary hepatocellular carccinoma 
Reduced mortality
51
Q

What are some of the aims/ benefits of chronic Hep C therapy

A 
Improved liver biochemistry 
improved histopathology 
reduced infectivity 
reduced incidence of primary liver cancer 
reduced mortality

Gastro (67 decks)

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