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Year 2 - GI System > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

What’s chronic hepatitis?

A

Hepatitis present for more than 6 months.

Causes variable changes in liver function

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2
Q

Name three causes of acute hepatitis.

A 
Infection 
Toxins/drugs/alcohol
Autoimmune
- wilson's 
- heamochromatosis
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3
Q

Name some causes of infectious hepatitis.

A 
EBV/cytomegalovirus
Toxoplasmosis
Leptospirosis
Q fever
Syphilis
Malaria
VHF - viral haemorrhagic fevers (e.g. Ebola)
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4
Q

What antibiotics are created in a hepatitis infection?

A

IgM is made first

IgG is made second

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5
Q

What class of virus is hepatitis A?

A

It’s an ssRNA virus enterovirus (infects the enteric tract)

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6
Q

How is hepatitis A transmitted?

A

Feaco-oral
Contaminated food or water.
Human only reservoir

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7
Q

How long can hepatitis A survive inside and outside of the body?

A

Can survive for months in contaminated water.

There is no chronic carriage in humans.

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8
Q

Is hepatitis A likely to return after one infection?

A

No- there is a good immunity after infection

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9
Q

What is acute hepatitis and what does it cause?

A

Inflammation of the liver.

It raises ALT/AST and causes jaundice and clotting problems.

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10
Q

What are the clinical features of hepatitis A?

A 
Fever
Abdominal Pain
Diarrhoea
Jaundice
Itch
Muscle Pain
However it is a self-limiting illness
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11
Q

What is the fatality rate of hepatitis A?

A

0.4% (1.75% in over 50s)

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12
Q

What is the treatment of hepatitis A?

A

No specific treatment

  • maintain hydration
  • avoid alcohol
  • no vaccine to treat
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13
Q

How is hepatitis A diagnosed?

A
  • Yields a positive IgM serology test
  • RNA can be found in blood and/or stool
  • IgG in the blood suggest they had it once, not currently
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14
Q

Who is normally vaccinated against hepatitis A?

A 
Travellers
Gay men
IVDU
Chronic liver disease patients
- to contain any outbreak
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15
Q

What class of virus is hepatitis E?

A

A calicivirus (ssRNA)

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16
Q

How is hepatitis E transmitted?

A

Feaco-oral

Feacal contamination of water supply

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17
Q

What is the incubation period of hepatitis E?

A

40 days

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18
Q

What are the clinical features of hepatitis E?

A 
Fever 
Abdominal Pain
Diarrhoea
Jaundice
Itch
Muscle Pain
Some rare neurological effects
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19
Q

What is the fatality rate of hepatitis E?

A

1-3% (15-25% in pregnant women)

20
Q

What is the treatment for hepatitis E?

A
  • supportive
  • pooled IgG doesn’t prevent infection
  • no vaccine to treat
21
Q

Does the body chronically carry hepatitis E?

A

Yes - but usually only in immunosuppressed patients

22
Q

Name the feaco-orally transmitted forms of hepatitis

A

A and E

23
Q

Name the blood bourne hepatitis viruses.

A

B, C and D

24
Q

What class of virus is hepatitis B?

A

It’s a DNA virus (the only one out of A,B,C,D and E)

25
Q

What are the vaccination guidelines for hepatitis B? (The most common hepatitis virus in the world?

A

Not commonly vaccinated against, unless in a high risk profession like medicine.

26
Q

How is hepatitis B transmitted?

A
  • vertical transmission
  • contaminated needle
  • child to child
  • transplants/fluid
  • most cases in the UK are from immigrants (picked up at antenatal screening)
27
Q

Acute hepatitis has an incubation period of 2-6 months, and can cause what symptoms?

A 
Fever 
Fatigue
Jaundice
Myalgia
Joint Pain
28
Q

If a child is infected with hepatitis B, what other symptoms might they have?

A
  • asymptomatic

- can lead to chronic infection

29
Q

How does clearing affect adults with hepatitis B?

A

At first they present symptomatically, but once they’ve cleared the virus, it attacks the liver

30
Q

What’s the fatality rate of hepatitis B?

A

0.5-1%

31
Q

What are the problems associated with chronic hepatitis B?

A
  • weight loss
  • chronic liver damage
  • abdominal pain/masses
  • fever
  • cachexia
  • bloody ascites
  • cirrhosis
  • hepatocellular carcinoma
  • death
32
Q

What’s the serology for hepatitis B?

A

Hep B antigen positive

33
Q

What’s the difference between a positive eAg serology and a negative?

A

eAg positive = high viral load, highly infectious, higher risk of CLD and hepatocellular carcinoma
eAg negative = opposite, but still has a small level of infection

34
Q

What is the treatment for hepatitis B?

A

Acute has no treatment
Chronic has two types of therapy
- immunological
- anti-viral drugs

35
Q

Describe the immunological and anti-viral treatment for hepatitis B.

A

Immunological
- pegylated interferon increases cellular immune response, but has lots of side effects
Anti-viral drugs
- tenofovir/entecavir suppress viral replication

36
Q

How is vertical transmission of hepatitis B prevented?

A
  • HBV vaccination for all newborns
  • HBV immunoglobulin if eAg is positive
  • Tenofovir is given to the mother during the last trimester
37
Q

Hepatitis D needs which other hepatitis virus to replicate?

A

Hepatitis B

  • so therefore has the same transmission
  • vertical transmission is rare
38
Q

How is hepatitis D acquired?

A

Co-infection with hepatitis B

Super infection of chronic HBV carries

39
Q

How is hepatitis D treated?

A

Pegylated interferon alpha

40
Q

How is hepatitis C transmitted?

A

Injections
Transfusion/transplant
Sexual
Vertical (rare)

41
Q

How is hepatitis C prevented?

A
  • no vaccine

- no reliable immunity after infection

42
Q

How is hepatitis C diagnosed?

A

Because it’s mostly asymptomatic, its normally picked up at screening.
HCV IgG positive means a chronic or cleared infection.
PCR positive means they currently have an infection

43
Q

What’s the treatment for hepatitis C?

A

There’s a cure

Pegylated interferon alpha and ribavirin

44
Q

In all hepatitis infections, what does sAg and sAb mean?

A 
sAg = surface antigen, a marker of infection 
sAb = surface antibody, a marker of immunity
45
Q

In all hepatitis infections, what does cAb mean?

A

cAb = core antibody, means they have chronic or acute hepatitis

46
Q

In all hepatitis infections, what does eAg and eAb mean?

A 
eAg = suggests high infection 
eAb = suggests low infection

Year 2 - GI System (18 decks)

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