Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

How is Hep A transmitted?

A

Faecal oral spread.

Grows in the liver and is excreted down into the bile gut and enters the gut and faeces.

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

Where is Hep A common?

A

Humanitarian crisis, porr hygiene/overcrowding.

UK- rare. Some cases are imported and occasional clusters in gay men and PWID

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

What are the clinical features of Hep A?

A

Acute hepatitis (no chronic infection)

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

When is the peak incidence of Hep A?

A

Older children/young adults

Very young children will have no symptoms

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

How does the laboratory confirm Hep A infection?

A

Clotted blood for serology looking for hepatitis A IgM.

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

What colour bottle do you put hepatitis blood samples into?

A

Gold top vaccucontainer

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

There is a Hep A vaccine. Who gets it?

A

Targeted people at risk.
Travelers
Gay men
PWID

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

Where is Hep E common?

A

In the tropics but in the UK is more common than Hep A

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

What causes UK cases of Hep E without foreign travel?

A

Exposure to Pigs, Deer or Rabbit or their meats.

These antimals are chronically infected

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

What is the clinical presentation of Hep E?

A

Acute inflammation of the liver

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

How is Hep E transmitted?

A

Faecal oral in the tropics

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

Can you get chronic infection with hep E?

A

Only if you are immunocomprimised.

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

Pregnant lady recently returned from the tropics with Hep E. Are you worried?

A

Yes as the tropical genotype of Hep E has been associated with severe disease in pregnant women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Is ther a Hep E vaccination?

A

Not yet

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

When can you get Hep D?

A

Only if you have Hep B. You can be co infected with Hep B and D at the same time or have Hep B and then later get Hep D.

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

What is the clinical importance of Hep D?

A

Exacerbates Hep B infection- rare in scotland

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

How is Hep B transmitted?

A

Sex
Mother to child (most significant worldwide)
Blood (acupuncture, tattoos, PWID healthcare)

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

When is chronic infection with Hep B more likely?

A

If the first exposure was in childhood.
Young children often assymptomatiic and then become chronically infected.
Older people get acute symptoms and are treated avoiding chronic infection

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

Who are the people at risk of Hep B in the UK?

A

PWID
People born in areas of intermediate or high prevalence.
Multiple sexual partners
Children of infected mother

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

What defines chronic hepatitis infection?

A

Infection for >6 months

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

How do you confirm Hep B infection in the laboratory?

A

Hepatitis B surface antigen (HBsAg) is present in the blood of all infectious individuals.
Hepatitis B e antigen (HBeAg) is usually present in the blood of highly infectious individuals
Hepatitis B viral DNA is always present in high titre in highly infectious individuals.
Hep B igM may be present in recently infected cases.
Anti Hep B antibody will be present in immunity

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

Hep B DNA tests are used in the diagnosis of Hep B. What else are they used for?

A

Predict risk of chronic liver disease and monitor therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is ATL?

A

A biochemical marker of inflammation of the liver

24
Q

There are 4 phases of Hep B chronic infection and it is complex relationship between chronic infection and chronic liver disease. What does this mean in terms of monitoring chronically infected Hep B patients?

A

You need to monitor them every 6-12 months no matter what as they may become more infectious or develop more damage

25
How can we reduce hepatitis B?
Safe blood transfusion, safe sex, needle exchange, prevent needlestick injuries, screen pregnant women to prevent mother child transmission.
26
Who gets the Hep B vaccine?
All children born since August 2017 | All older risk children and adults (healthcare workers)
27
What is the post exposure prophylaxis of Hep B?
Vaccine and Hyperimmune Hep B immunoglobulin. | This works because the incubation of the virus is weeks long
28
How is Hep C transmitted?
Similar to Hep B. | Blood, Sex, Mother to child (less common)
29
Is there a Hep C vaccine?
No
30
What percentage of Hep C infection will become chronic?
75%. | Just 25% will manage to keep the virus out of their blood and liver.
31
Is the chance of chronic infection with Hep C depend on age?
No- it's independent of age
32
How can infection with Hep B or C lead to primary hepatocellular carcinoma?
Chronic infection => chronic hepatitis => Cirrhosis => primary hepatocarcinoma or chronic liver failure => death
33
Can you get a spontaneous cure from Hep B after years of infection?
Yes- its not uncommon
34
Can you get a spontaneous cure of chronic Hep C infection?
No- spontaneous cures are not seen
35
How long does it take for chronic hepatitis infection to cause cirrosis and hepatocellular carcinoma?
``` Cirrhosis = 20 years Cancer = 30 years ```
36
Why is chronic hepatitis quite a large problem?
Most people are asymptomatic when infected and later get chronic infection and hepatitis cirrhosis etc, before it is diagnosed
37
What percentage of Hep B infection in adults will lead to a chronic infection?
<5% | NB: This is much greater in children as they are often asymptomatic
38
How is Hep C diagnosed in at risk individuals?
1) Test for the antibody for Hep C virus. => Negative- not infected/ discharge. Postitive- past or active infection. 2) Then Test for Hep C virus RNA by PCR. => Negative- past infection/discharge. Positive- active infection
39
How is acute viral hepatitis managed?
No antivirals if acute. Monitor for encephalopathy and resolution of Hep B, C or E if immunocomprimised. Notify public health Immunise all contacts. Test for other infections if at risk- HIV, syphilis etc and vaccinate against other infections if at risk
40
If hepatitis a notifiable disease?
YES- to public health
41
What is important when choosing antivirals for chronic hep C infection?
Genotype of the virus (1-6). This can be determined by sequencing the virus. NB: genotype is not important in Hep B.
42
If you diagnose chronic hepatitis, which vaccinations should the patient receive?
Other Hepatitis viruses to prevent furtehr insult to the liver If cirrhotic: influenza and pneumococcal viruses
43
What advice do you give to chronic hepatitis patients?
Try to control the infection. Sex etc Decrease alcohol consumption as much as possible Hepatocellular carcinoma screening : important in cirrhosis.
44
WHat is the hepatocellular carcinoma screening?
AFP- serum- alpha fetoprotein and USS
45
Who should be treated for hepatitis?
Those with chronic Hep C infection or chronic Hep B infection with HepB DNA above a cirtain threshold Cirrhotic patients are treated as a priority
46
What are the contra indications for treatment of hepatitis?
Liver cancer at presentation | HIV co infection- treat the HIV first
47
How can you test for fibrosis and inflammation of the liver?
Fibrosis- fibroscan measures elasticity of the liver | Inflammation = Raised ALT
48
When should you treat hepatitis?
Before complications and when there is evidence of inflamation
49
What is the injectable drug occasionally used to treat hepatitis and what are the side effects?
Interferon alpha (peginterferon) Side effects: flu like symptoms Thyroid disease, autoimmune disease and psychiatric disease. (Aviod if already has these diseases)
50
Ribavin is used to treat hepatitis. What is the common side effect?
Anaemia
51
What is the most common therapy for hepatitis B?
Life long oral therapy. | Suppression of hep B DNA to undetectable levels.
52
If you can remove HBsAg from the blood of a Hep B patient is this a cure?
YES | Reduction of Hep B DNA is suppression and loss of HBeAg is more enduring supression
53
What is a Sustained Virological Response (SVR)?
RNA negative 6 moths after the end of therapy. Virological cure from hepatitis C. Relapse is rare but reinfection can occur
54
What are the current antivirals used in Hepatitis C therapy?
``` Simeprevir Ledipasvir Daclastavir Ombitasvir Elbasvir Grazoprevir Called NS3, NS4A etc ```
55
How long is Hep C therapy for?
Up to 12 weeks

GI (48 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions