Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastrointestinal > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

What are the common causes of viral hepatitis. (5)

A 
Hepatitis A. 
Hepatitis B.
Hepatitis C. 
Hepatitis D. 
Hepatitis E.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the less common causes of viral hepatitis. (2)

A

Cytomegalovirus.

Epstein-Barr Virus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the rare causes of viral hepatitis. (2)

A

Herpes Simplex.

Yellow Fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which of the viral hepatitis viruses are commonly transferred via faeces. (2)

A

Hepatitis A.

Hepatitis E.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which of the viral hepatitis viruses are commonly transferred via blood. (3)

A

Hepatitis B.
Hepatitis C.
Hepatitis D.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which of the viral hepatitis viruses are commonly transferred via saliva. (3)

A

Hepatitis A.
Hepatitis B.
Hepatitis C.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which of the viral hepatitis viruses are commonly transferred via sexual contact. (2)

A

Hepatitis B.

Hepatitis D.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which of the viral hepatitis viruses can cause chronic infection. (3)

A

Hepatitis B.
Hepatitis C.
Hepatitis D.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the main route of transmission of hepatitis A virus. (2)

A

Faecal-oral.

Shellfish.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What sort of virus is the hepatitis A virus.

A

RNA virus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Does hepatitis A cause cirrhosis.

A

No.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What increases the chances of contracting hepatitis A virus.

A

Poor hygiene correlates with increased risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the symptoms associated with hepatitis A viral infection. (9)

A 
Nausea. 
Anorexia. 
Vomiting. 
Diarrhoea. 
Weakness. 
Fever.
Malaise. 
Arthralgia. 
Dark urine.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the physical signs associated with hepatitis A infection. (4)

A

Jaundice.
Hepatomegaly.
Splenomegaly.
Lymphadenopathy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the investigations carried out if you suspect hepatitis A infection. (5)

A

LFTs: Raised transaminases (very high in acute infection), raised bilirubin (indicates the degree of liver damage).
A prolonged PT time indicates the severity of the hepatitis.
FBC: Leucopenia with a relative lymphocyosis.
AST and ALT rise 22-40days after exposure.
Serological tests are usually carried out to confirm the aetiology of infection. In hepatitis A, only anti-HAV IgM are of diagnostic value.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the treatment for a patient with viral hepatitis A infection. (3)

A

Supportive.
Avoid alcohol.
Rarely, interferon-alpha for fulminant hepatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How long do individuals infected with hepatitis A virus excrete the virus in their faeces before exhibiting symptoms.

A

Asymptomatic individuals excrete the virus in their faeces for about 2-3 weeks before the onset of symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

For how long do patients infected with hepatitis A virus excrete the virus in their faeces after the onset of symptoms.

A

For 2 weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Is infection with hepatitis A virus more common in childhood or adulthood.

A

In childhood.

It is often asymptomatic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where is infection with hepatitis A virus more common.

A

Infection is more common in areas of overcrowding and poor sanitation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Does a chronic carrier state occur in patients infected with hepatitis A virus.

A

No.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some complicates of acute viral hepatitis. (5)

A 
Acute liver failure. 
Cholestatic hepatitis (hepatitis A).
Aplastic anaemia. 
Chronic liver disease and cirrhosis (hepatitis B and C).
Relapsing hepatitis.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What sort of virus is hepatitis B.

A

DNA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the routes of transmission for hepatitis B. (3)

A

Parenteral.
Sexual.
Vertical.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the symptoms of hepatitis B infection. (9)

A 
Nausea. 
Anorexia. 
Vomiting. 
Diarrhoea. 
Weakness.
Fever. 
Malaise. 
Arthralgia. 
Dark urine. 
Symptoms tend to be more severe than that of hepatitis A.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the signs of hepatitis B infection. (6)

A 
Pruritus. 
Tender hepatomegaly. 
Jaundice. 
Urticaria.
Lymphadenopathy. 
Splenomegaly.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the only carrier of hepatitis B.

A

Humans.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the most common cause of chronic liver disease and hepatocellular carcinoma worldwide.

A

Hepatitis B infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What type of infection does hepatitis B cause. (2)

A

Acute viral hepatitis.

Chronic viral hepatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the most common route of transmission of hepatitis B worldwide.

A

Vertical.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the risk of chronic infection of hepatitis B with horizontal transmission.

A

10%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the risk of chronic infection of hepatitis B with vertical transmission.

A

90%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are some routes of horizontal transmission of hepatitis B. (5)

A 
IVDU. 
Infected unscreened blood products.
Tattoos/acupuncture needles. 
Sexual contact. 
Close living quarters.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are some complications of chronic hepatitis B infection. (5)

A 
Hepatocellular carcinoma. 
Cirrhosis. 
Fulminant hepatic failure. 
Cholangiocarcinoma. 
Cryoglobulinaemia.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the five phases of chronic hepatitis B infection.

A
  1. Immune tolerant phase.
  2. Immune reactive (HBeAg - positive chronic hepatitis phase).
  3. Inactive carrier phase.
  4. HBeAg- negative chronic hepatitis phase.
  5. HBsAg-negative phase.

Note that not all patients will go through all five phases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the serology in hepatitis B infections. (7)

A

HBsAg: it is the first serological marker, it usually becomes undetectable at 6 months.

HBsAb: This becomes detectable once HBsAg clears. It remains indefinitely.

HBcAg: this is not routinely detectable.

HBcAb: this is detectable 1-2 weeks after HBsAg (IgM initually, then IgG)

HBeAg: this occurs shortly after HBsAg. It correlates with viral replication.

HBeAb: it correlates with lower viral replication and infectivity.

HBV DNA by PCR: this quantifies viral replication.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How is hepatitis B diagnosed.

A

Serology testing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is HBsAg used for.

A

It is used as an indicator of active infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What does the persistence of HBsAg for more than 6 months usually indicate.

A

Chronic hepatitis B infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is HBsAg indicative of. (2)

A

It is the first serological marker in acute hepatitis B infection.
In acute cases, it becomes undetectable at 6 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is HBsAb indicative of. (2)

A

It is the antibody to HBsAg.
It is detectable once HBsAg has cleared.
It remains indefinitely.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is HBcAg indicative of.

A

It is an antigen that is not detectable in the blood.

43
Q

What is HBcAb indicative of. (3)

A

It is the antibody to HBcAg.
It is detectable early in the illness (1-2weeks after HBsAg).
It is detected as IgM initially, then IgG.

44
Q

What is HBeAg indicative of.

A

It is the antigen that occurs shortly after HBsAg.

It correlates with active viral replication in the liver.

45
Q

What is HBeAb indicative of. (2)

A

It is the antibody to HBeAg.

It correlated with lower viral replication levels.

46
Q

What is the purpose of HBV DNA by PCR. (2)

A

It quantified viral replication.

It is a way of measuring viral load.

47
Q

How do you treat an acute hepatitis B infection. (3)

A

Treatment is supportive, with monitoring for acute liver failure. (it occurs in >1% of cases)
Alcohol avoidance is recommended.
Refer everyone with chronic liver inflammation for antiviral therapy.

48
Q

In what percentage of patients with acute hepatitis B infection does a full recovery occur.

A

90-95%.

49
Q

In what percentage of patients who contract hepatitis B go on to develop chronic hepatitis B.

A

10%.

50
Q

When does recovery from acute hepatitis B infection occur.

A

Within 6 months.

51
Q

How do you treat a chronic hepatitis B infection.

A 
Antivirals are used (although none can completely eradicate the infection).
Antivirals used are:
Lamivudine.
Pegylated interferon. .
Adefovir. 
Tenofovir. 
Entecavir.
Telbivudine. 
IFN-alpha.
52
Q

What is the purpose of antiviral therapy in chronic hepatitis B infection. (3)

A

HBeAg seroconversion.
Reduction in HBV-DNA.
Normalisation of LFTs.

53
Q

How infectious is hepatitis B.

A

It is about 10 times more infectious than hepatitis C. (which in turn is about 10 times more infectious than HIV).

54
Q

How can you prevent hepatitis B infection.

A

There is a vaccine, containing HBsAg, that is capable of producing active immunisation in 95% of normal individuals.

55
Q

What sort of virus is hepatitis D.

A

RNA virus.

56
Q

How does Hepatitis D cause infection.

A

It can only be present with hepatitis B.

It does not exist independently.

57
Q

What are the symptoms of hepatitis D.

A

They are the same as those for hepatitis B.

58
Q

Where is HBV endemia. (3)

A

Parts of the Mediterranean Basin.
Africa.
South America.

59
Q

What investigations are used to diagnoses hepatitis D. (2)

A

HdAb are produced in response to HdAg antigens (anti-HDV) which can be detected.
RNA by PCR.

60
Q

How do you manage a patient with hepatitis D.

A

Effective management of the hepatitis B infection will prevent the hepatitis D infection.

61
Q

What sort of virus is hepatitis C.

A

RNA.

62
Q

How many genotypes exist for hepatitis C.

A

6.

63
Q

_______infection with hepatitis C is ______

A

Acute infection.

Rare.

64
Q

When do patients usually become aware that they are infected with hepatitis C.

A

When they develop chronic liver disease.

65
Q

What percentage of individuals exposed to hepatitis C become chronically infected.

A

80%

66
Q

Late spontaneous viral clearance of hepatitis C is _____

A

Rare.

67
Q

What are the symptoms of hepatitis C infection. (2)

A

Patients tend to by asymptomatic until they progress to chronic liver disease, or it is an incidental finding of abnormal LFTs.
Fatigue may be pronounced.

68
Q

What are some risk factors for hepatitis C infection. (6)

A 
IVDU (95% of new cases in UK).
Unscreened blood products. 
Vertical transmission (3% risk).
Needlestick injury (3% risk).
Iatrogenic parenteral transmission.
Sharing toothbrushes/rasors.
69
Q

What are the signs of hepatitis C infection. (2)

A

Jaundice (rare, usually only appears in end-stage cirrhosis).
Hepatomegaly.

70
Q

What are the investigations for a patient suspected to have hepatitis C infection. (3)

A

HCV antibody (may take 6-12 weeks to appear following acute infection).
HCV RNA by PCR (as early as 2-4 weeks after infection).
LFTs may be normal or show fluctuating serum transaminases.

71
Q

How do you determine the degree of liver fibrosis in hepatitis C infection.

A

Liver biopsy.

Serum transaminase levels in hepatitis C are a poor predictor of the degree of liver fibrosis.

72
Q

What is the most common genotype of hepatitis C infection in Northern Europe. How easy is it to eradicate.(2)

A
  1. It is less easy to eradicate with traditional pegylated interferon alpha/ribavirin based treatments than genotypes 2 and 3.
73
Q

What is the aim of hepatitis C treatment.

A

Treatment aims to eradicate the infection.

74
Q

What is the treatment for hepatitis C infection. (2)

A

Triple therapy with pegylated interferon-alpha, ribavirin and protease inhibitors.
Liver transplant.

75
Q

What is the response rate for hepatitis C treatment.

A

40-70%

76
Q

What adversely affects the treatment of hepatitis C infection. (7)

A 
HCV genotypes 4, 5, or 6. 
Increased viral load. 
Older patients. 
Delay before treatment is started. 
Black patients (versus caucasians).
Men. 
If HIV positive.
77
Q

What are some complications associated with hepatitis C infection. (7)

A 
Glomerulonephritis. 
Cryoglobulinaemia. 
Thyroiditis. 
Autoimmune hepatitis. 
PAN. 
Polymyositis. 
Porphyria cutanea tarda.
78
Q

What are risk factors for the progression of chronic hepatitis C to cirrhosis. (6)

A 
Immunocompromised (eg HIV). 
Alcohol misuse. 
Male. 
Older. 
Prothrombotic states. 
Higher viral load.
79
Q

What is the prevalence of hepatitis C infection in the UK.

A

> 200,000

80
Q

What is the progression rate of chronic hepatitis C infection to cirrhosis.

A

20% in 20 years.

81
Q

What is the 5 and 10 year survival for patients who have progressed from hepatitis C infection to cirrhosis.

A

5 year = 95%.

10 year = 81%.

82
Q

How many people with cirrhosis (due to hepatitis C) will develop complications within 10 years.

A

25%

83
Q

What percentage of patients who have developed complications (such as ascites) due to hepatitis C infection will go on to develop primary hepatocellular carcinoma.

A

2-5%/year.

84
Q

What is the 5 year survival rate for patients who have developed cirrhosis (due to hepatitis C infection).

A

5 years = 50%

85
Q

What sort of virus is hepatitis E.

A

RNA.

86
Q

What is the route of transmission for hepatitis E.

A

Faecal-oral.

87
Q

What are the clinical presentations of hepatitis E.

A

Very similar to those of hepatitis A.

88
Q

How does hepatitis E present.

A

It presents as a self-limiting acute hepatitis.

89
Q

Does hepatitis E cause chronic liver disease.

A

Not usually. Although some cases have been described.

90
Q

What is a complication of hepatitis E infection.

A

In pregnant women, it is associated with the development of fulminant hepatic failure (20%).

91
Q

What is the treatment for hepatitis E infection. (2)

A

Supportive.

Prevention by improvements in sanitation.

92
Q

Where is hepatitis E usually found. (2)

A

India.

Middle East.

93
Q

Where is hepatitis A endemic to. (2)

A

Africa.

South America.

94
Q

What immunoglobulin is detectable for life after hepatitis C infection.

A

IgG.

95
Q

Is there immunisation available for hepatitis A. (2)

A

Yes.

Havrix Monodose is an inactive protein derived from HAV.

96
Q

What is the incubation period for hepatitis A.

A

2-6weeks.

97
Q

What is the incubation period for hepatitis B.

A

1-6months.

98
Q

Can a carrier state develop after infection with hepatitis B.

A

Yes.

99
Q

What is the most common hepatitis occurring worldwide.

A

Hepatitis A.

100
Q

What is the prognosis for patients with Hepatitis A.

A

Excellent.

Mortality is 0.1%, but increases with age.

101
Q

What is death due to in cases of hepatitis A infection.

A

Due to fulminant hepatic necrosis.

102
Q

What is ‘cholestatic viral hepatitis’

A

A potential consequence of hepatitis A infection.

It is a severe jaundice with cholestasis which lasts between 7-20 weeks.

103
Q

What is ‘post-hepatic syndrome’

A

Where patients may complain of debility for several months following resolution of their symptoms (hepatitis A).

Gastrointestinal (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions