Viral hepatitis

Question 1

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

Answer 1

Liver disease

Question 2

How is hepatitis A transmitted?

Answer 2

Feacal-oral spread

Question 3

What hepatitis is related to poor hygiene and overcrowding?

Answer 3

Heptatitis A

Question 4

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

Answer 4

Older children and young adults

Question 5

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

Answer 5

1. Clotted blood for serology

2. Hepatitis A IgM

Question 6

What are the two methods for control of hepatitis A?

Answer 6

Hygiene

Vaccine prophylaxis

Question 7

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

Answer 7

Hepatitis E

Question 8

How is hepatitis E transmitted?

Answer 8

Faecal-oral

Question 9

Where is the evidence of chronic hepatitis E infection?

Answer 9

In pigs

Question 10

Which virus is only found with hepatitis B?

Answer 10

Hepatitis D

Question 11

What are three methods of transmission of hepatitis B?

Answer 11

1. Sex
2. Mother to child
3. Blood

Question 12

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

Answer 12

Hepatitis B

Question 13

What does the HBsAg indicate?

Answer 13

Patient is infected and infectious

Question 14

What does anti-HBe indicate?

Answer 14

Low infectivity

Question 15

What is done in the laboratory to confirm hepatitis B?

Answer 15

HBsAg

Question 16

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

Answer 16

6 months

Question 17

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

Answer 17

High titre

Question 18

What hepatitis B cases have Hep B IgM present?

Answer 18

Acute

Question 19

What are Anti-HBs present in?

Answer 19

Immunity

Question 20

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

Answer 20

1. Vaccine

2. plus HBIG (hyperimmune Hep B immunoglobulin)

Question 21

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

Answer 21

Hepatitis C

Question 22

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

Answer 22

Test for antibody to hepatitis C virus

Question 23

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

Answer 23

Test for hepatitis C virus RNA by PCR

Question 24

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?

Answer 24

Negative - past infection

Positive - active infection

Question 25

Is there a vaccine for hepatitis C?

Answer 25

No

Question 26

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

Answer 26

Spontaneous cure

Question 27

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

Answer 27

1. Encephalopathy | 2. Resolution

Question 28

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

Answer 28

Public health

Question 29

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

Answer 29

Influenza and pneumococcal

Question 30

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

Answer 30

1. Serum alpha fetoprotein (AFP) and ultrasonography

Question 31

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

Answer 31

Adefovir | Entecavir

Question 32

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

Answer 32

Chronic hepatitis B infection

Question 33

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

Answer 33

Ribavirin

Question 34

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

Answer 34

1. HCV RNA present and genotype known | 2. HBsAg and Hep B DNA present

Question 35

What does increased ALT suggest?

Answer 35

Biochemical evidence of inflammation

Question 36

What condition is a contraindication for hepatitis treatment?

Answer 36

Liver cancer

Question 37

What are four side effects of interferon alpha?

Answer 37

Flu like symptoms, autoimmune disease, psychosis, thyroid disease

Question 38

What drug for hepatitis treatment is a human protein?

Answer 38

Interferon alpha

Question 39

Give one side effect of ribavirin?

Answer 39

Anaemia

Question 40

Give two side effects of telaprevir and boceprevir?

Answer 40

Rash and aneamia

Question 41

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

Answer 41

Peginterferon - sustained cure possible | Antiviral - suppression

Question 42

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

Answer 42

Cirrhosis and primary hepatocellular carcinoma

Question 43

What is the aim of chronic hepatitis C therapy?

Answer 43

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

Question 44

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

Answer 44

Peginterferon alfa anf ribavirin