Viral Hepatitis

Question 1

Define hepatitis

Answer 1

Inflammation of the liver

Question 2

How are Hep B and C spread

Answer 2

Bodily fluids

Question 3

Which types of hepatitis leads onto chronic illness

Answer 3

B and C

Question 4

What are the symptoms of viral hepatitis

Answer 4

Nausea, jaundice, stomach ache, poor appetite, fever, fatigue, GI upset, vomiting

Question 5

What is the virus structure for hepatitis B

Answer 5

• double stranded DNA

- enveloped

Question 6

What is the viral structure of hep C

Answer 6

• single stranded RNA

- enveloped

Question 7

What is the viral structure for hepatitis A and E

Answer 7

• single stranded RNA

- non enveloped

Question 8

What would the blood tests for bilirubin, ALT and ALP for a positive hepatitis result look like (liver function test)

Answer 8

Increased bilirubin - liver cant conjugate bilirubin properly so cant be excreted therefore builds up
Increased ALT - enzyme normally found inside hepatocytes but are released in damage. Indicates the degree of inflammation.
Slightly Increased ALP - enzyme found in bile ducts so an increase indicates blockage of bile duct (through inflammation)

Question 9

What are the types of jaundice

Answer 9

prehaptic = increased haemoglobin breakdown

Cholestatic

• intrahepatic = bilirubin not conjugated so cant be excreted (hepatitis causes this)
• extrahepatic = gall bladder blocked

Question 10

What happens to the albumin and coagulation factor levels in hepatitis

Answer 10

Decreased due to the liver damage

Question 11

Who is most at risk of transmission of hep b

Answer 11

• vertical transmission is the highest risk
• sexual contact
• injecting drugs
• needlestick

Question 12

What is the incubation period for hepatitis

Answer 12

6 weeks to 6 months

Question 13

How common is it for hep b to become chronic

Answer 13

Rare - less than 10% of adults

Question 14

Describe the order of the hepatitis B serology results

Answer 14

• surface antigen produced by virus appears first
• e-antigen then appears
• core antibody (IgM) appears
• e-antibody appears
• surface antibody then disappears last
• core antibody IgG persists for life

Question 15

What is the definition of chronic hep b

Answer 15

Persistence of HBsAG after 6 months

Question 16

What is the treatment for hep b

Answer 16

No cure as the virus integrates into the host genome so need anti-viral to suppress replication

Question 17

What is the hep b vaccination

Answer 17

Genetically engineered surface antigen which produces a surface antibody response

Question 18

Who is at risk of transmission of hep C

Answer 18

• people who inject drugs
• sexual contact
• vertical
• blood transfusion
• needlestick

Question 19

What is the likelihood of chronic infection by hep C

Answer 19

80%

This results in liver disease, hepatocellular carcinoma, transplant

Question 20

How many people experience symptoms for hep C

Answer 20

20% have vague symptoms. 80% have none

Question 21

What blood tests can be used to determine hep C

Answer 21

anti-Hep C antibody test which remains after cure

Also do a viral PCR which is positive shows current infection

Question 22

What is the treatment for hep C

Answer 22

Antiviral drug combination for 8-12 weeks but there’s no vaccine

Question 23

What is the risk of transmission of hep C and B by needlestick

Answer 23

B = 1/3
C = 1/30

Question 24

What must be done if needlestick occurs

Answer 24

• bleed and wash
• collect blood
• PEP

Question 25

What prevents hep B transmission

Answer 25

Vaccination