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JL Gastrointestinal > Viral hepatitis > Flashcards

Viral hepatitis Flashcards

1
Q

What id the chief or sole clinical manifestation of hepatitis viruses?

A

Liver disease

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2
Q

How is hepatitis A transmitted?

A

Feacal-oral spread

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3
Q

What hepatitis is related to poor hygiene and overcrowding?

A

Heptatitis A

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4
Q

In what patients is there peak incidence of symptomatic hepatitis A?

A

Older children and young adults

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5
Q

What are the two investigations for labaratory confirmation of hepatitis A?

A
  1. Clotted blood for serology

2. Hepatitis A IgM

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6
Q

What are the two methods for control of hepatitis A?

A

Hygiene

Vaccine prophylaxis

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7
Q

What virus is more common in tropics, clinically like hepatitis A and has become more common than hep A in UK?

A

Hepatitis E

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8
Q

How is hepatitis E transmitted?

A

Faecal-oral

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9
Q

Where is the evidence of chronic hepatitis E infection?

A

In pigs

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10
Q

Which virus is only found with hepatitis B?

A

Hepatitis D

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11
Q

What are three methods of transmission of hepatitis B?

A
  1. Sex
  2. Mother to child
  3. Blood
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12
Q

What virus is likely with unscreened transfusions, needlesticks and tattoos?

A

Hepatitis B

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13
Q

What does the HBsAg indicate?

A

Patient is infected and infectious

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14
Q

What does anti-HBe indicate?

A

Low infectivity

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15
Q

What is done in the laboratory to confirm hepatitis B?

A

HBsAg

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16
Q

How long does HBsAg have to be present for it to be chronic infection?

A

6 months

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17
Q

What is the Hep B virus DNA like in highly infectious individuals?

A

High titre

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18
Q

What hepatitis B cases have Hep B IgM present?

A

Acute

19
Q

What are Anti-HBs present in?

A

Immunity

20
Q

What are two post-exposure prohpylaxis methods for hepatitis B?

A
  1. Vaccine

2. plus HBIG (hyperimmune Hep B immunoglobulin)

21
Q

What hepatitis virus has similar transmission to hepatitis B (e.g. sex etc)?

A

Hepatitis C

22
Q

What should you test for if a patient is at risk of hepatitis C or with signs of chronic liver disease?

A

Test for antibody to hepatitis C virus

23
Q

When testing for hepatitis C, if the antibody test comes back positive (past or active infection), what is the next step?

A

Test for hepatitis C virus RNA by PCR

24
Q

If the test for hepatitis C virus RNA by PCR is negatie what does it mean, and if it is positive what does it mean?

A

Negative - past infection

Positive - active infection

25
Q

Is there a vaccine for hepatitis C?

A

No

26
Q

Once chronic hepatitis C infection is established, what is not seen?

A

Spontaneous cure

27
Q

What two factors should you monitor when managing acute viral hepatitis?

A
  1. Encephalopathy

2. Resolution

28
Q

Who should be notified when there is an acute viral hepatitis case?

A

Public health

29
Q

If cirrhotic, what vaccinations should be given to manage chronic viral hepatitis?

A

Influenza and pneumococcal

30
Q

For patients with chronic viral hepatitis, how should hepatocellcular carcinomas be screened for?

A
  1. Serum alpha fetoprotein (AFP) and ultrasonography
31
Q

What are the two main drugs used for chronic hepatitis B therapy?

A

Adefovir

Entecavir

32
Q

What are tenofovir, lamivudine, telbivudine and interferon used in?

A

Chronic hepatitis B infection

33
Q

In chronic hepatitis C infection, what is given with peg interferon alpha?

A

Ribavirin

34
Q

For treating chronic hepatitis infections, what to factors must be present?

A
  1. HCV RNA present and genotype known

2. HBsAg and Hep B DNA present

35
Q

What does increased ALT suggest?

A

Biochemical evidence of inflammation

36
Q

What condition is a contraindication for hepatitis treatment?

A

Liver cancer

37
Q

What are four side effects of interferon alpha?

A

Flu like symptoms, autoimmune disease, psychosis, thyroid disease

38
Q

What drug for hepatitis treatment is a human protein?

A

Interferon alpha

39
Q

Give one side effect of ribavirin?

A

Anaemia

40
Q

Give two side effects of telaprevir and boceprevir?

A

Rash and aneamia

41
Q

What is the difference in end result with chronic hepatitis B infection using peginterferon or antiviral drugs?

A

Peginterferon - sustained cure possible

Antiviral - suppression

42
Q

What are two conditions which can follow on from hepatitis B chronic infection?

A

Cirrhosis and primary hepatocellular carcinoma

43
Q

What is the aim of chronic hepatitis C therapy?

A

Response defined by loss of HCV RNA in blood sustained to 6 months after end of therapy

44
Q

What two older antivrals for hepatitis C can be used against all genotypes?

A

Peginterferon alfa anf ribavirin

JL Gastrointestinal (33 decks)

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