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MD3002 > viral hepatitis > Flashcards

viral hepatitis Flashcards

1
Q

what are non viral causes of hepatitis

A 
toxoplasmosis (a parasite)
drugs- paracetamol 
alcohol
poisons
other- pregnancy, circulatory insufficiency
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2
Q

what are the stages of viral replication

A
  • Adsorption
  • Penetration
  • Uncoating
  • Replication of nucleic acid
  • Maturation / assembly
  • Release
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3
Q

what are the features of Hep A

A 
• Picornaviridae family
• Single-stranded RNA virus
• Non-enveloped virus (naked)
• Only 1 serotype
usually mild and acute
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4
Q

how is hep A spread

A 
faecal oral 
poor hand hygeine
contaminated food and water 
shellfish (improperly cooked)
not common in the uk
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5
Q

what are the stages of HAV infection

A

• Incubation period of 2-4 weeks (prodromal
phase)
• Virus excreted in faeces for 1-2 weeks before
symptoms
• Translocation from GI tract to blood
• Infection of liver cells
• Passage to biliary tract and back to GI tract
• Excretion in faeces

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6
Q

what are the features of HAV

A 
• Fever, anorexia
flu like symptoms, joint pain
• Nausea, vomiting
• Jaundice
• Dark urine, pale stools
• Liver moderately enlarged
• Spleen palpable in 10% patients
• No chronic carriage
• Diagnosed by presence of anti-HAV IgM
• Prognosis excellent (mortality 0.1%) in young adults
• Death if fulminant hepatic necrosis occurs
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7
Q

what is the treatment for HAV

A
  • No specific treatment
  • Maintain comfort and nutritional balance
  • Fluid and electrolyte replacement
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8
Q

How is HAV prevented

A
  • Vaccine

* Good hygiene

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9
Q

what are the viral features of HBV

A
  • Hepadnaviridae
  • Double-stranded DNA virus
  • Enveloped virus
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10
Q

how is HBV transmitted

A

• Sexual intercourse
• Intra-uterine, peri- and post-natal infection
• Blood or blood products
• Contaminated needles and equipment used
by intravenous drug users
• In association with tattooing, body piercing
and acupuncture
• Contaminated haemodialysis equipment

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11
Q

what are the HBV stages of infection

A
  • Incubation period of 2-4 months
  • 50% patients develop chronic active hepatitis
  • 20% of these proceed to cirrhosis
  • 1-4% of these risk developing liver cancer
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12
Q

what does icteric mean

A

jaundiced

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13
Q

what are the clinical features of preicteric HBV

A 
can be severe, acute or sometimes chronic 
worse with hep d 
Malaise
anorexia
nausea 
pain in URQ
emesis 
flu like symptoms
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14
Q

how is HBV treated

A

Pegylated interferon
Nucleoside analogues such as oral lamivudine
may not be treated

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15
Q

how is HBV prevented

A
  • Vaccination: 3 injections over 6 months
  • HBV immunoglobulin
  • Blood screening
  • Needle exchange programmes
  • Sexual health education
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16
Q

what are the viral features of hep c

A

Flaviviridae
• Single-stranded RNA
• Enveloped virus

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17
Q

what are the symptoms of hep c

A 
often subclinical 
usually chronic 
 may be assymptomatic 
flu-like symptoms, such as muscle aches and a fever
feeling tired all the time
loss of appetite
abdominal pain
feeling and being sick

may develop to cirrhosis or carcinoma

no vaccine

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18
Q

how is hep C spread

A 
• Blood and blood products
• Blood contaminated needles
• Tattooing, body piercing, acupuncture
• Haemodialysis
mother to baby
19
Q

what are the stages of hep c infection

A

virus replicates in hepatocytes

incubation period of several months

20
Q

how can HCV be tested

A

blood test based on NAAT

21
Q

how is HCV treated

A

ribavirin and pegylated interferon

22
Q

what are the viral features of hep D

A

small circular single stranded RNA

defective

23
Q

what are the features of hep D

A

•Found as co-infection with HBV
•HBV serves as helper virus for infectious HDV production
•Transmitted percutaneously, sexually, from infected blood
•Chronic HBV carriers are at risk for infection with HDV.
•No specific treatment is available
chronic infection

24
Q

what are the viral features of hep E

A
  • Caliciviridae
  • Single-stranded RNA
  • Non-enveloped virus
25
Q

how is hep E transmitted

A
  • Waterborne disease
  • Peak incidence in young adults
  • Incubation period 3-8 weeks
26
Q

what are the symptoms of HEP

A

•Usually self-limiting
•Can be life-threatening in pregnant woman
•Signs and symptoms are similar to other acute forms of hepatitis
acute and not usually a problem unless pregnant

27
Q

what are the other causes of viral hepatitis

A
  • Epstein-Barr virus
  • Cytomegalovirus
  • Yellow fever virus
  • Adenoviruses
  • Bunyaviruses
  • Flaviviruses
28
Q

is hepatitis A acute or chronic

A

acute

29
Q

what does picorniviridae cause

A

Hep A

30
Q

what does hepadnaevirus cause

A

hep B

31
Q

what does flaviviridae cause

A

hep c

32
Q

what does herpeviridae/ caliciviridae cause

A

hep e

33
Q

what does deltavirus cause

A

hep d

34
Q

what is the only virus that is double stranded

A

hep B

35
Q

what vaccines are available

A

hep A and B

36
Q

what type of hepatitis does hep B cause

A

usually acute, may be chronic

may lead to cirrhosis or liver cancer

37
Q

is hep c acute or chronic

A

chronic- 70%
usually asymptomatic for many years
eventually cirrhosis if untreated

38
Q

which two infections are linked

A

D and B

D is chronic with B

39
Q

what is the severity of hep E

A

usually acute
unless pregnant- may be fulminant
or immunocompromised - may be chronic
other wise similar to hep A

40
Q

where is hep a most common

A

africa
south america
indian subcontinent

41
Q

where is hep B most common

A

canada
africa
indian subcontinent

42
Q

how do you tell that HBV has become chronic

A

presence of HBsAg and absence of antibodies

43
Q

which hepatitis is waterborne

A

hep e

MD3002 (56 decks)

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