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Gastrointestinal > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

transmission of hep A

A 
faecal-oral
poor hygiene
overcrowding 
gay men 
PWID
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2
Q

clinical symptoms of hep A

A

acute hepatitis - no chronic infection

peak incidence of symptomatic disease in older children/young adults

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3
Q

tests for hep A

A

laboratory confirmation;
clotted blood for serology
hep A IgM detected

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4
Q

control of hep A

A 
usually results in complete resolution 
hygiene 
vaccine prophylaxis - long term protection 
monitor for encephalopathy 
notify public health
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5
Q

clinical symptoms of hep E

A

similar to hep A;
acute hepatitis - no chronic inaction
peak incidence of symptomatic disease in older children/young adults

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6
Q

epidemiology of hep E

A

tropical continents
most common acute hep virus
tropical genotypes associated with severe disease in pregnant woman
immunocompromised humans can get chronic infection

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7
Q

transmission of hep E

A

faecal-oral

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8
Q

control of hep E

A

no vaccine available
monitor for encephalopathy
monitor for resolution
notify public health

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9
Q

aetiology of hep E

A

animals can be infected and are source of infection

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10
Q

epidemiology of hep D

A

only found with hep B - parasite of a parasite
exacerbates hep B infection
rare

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11
Q

transmission of hep B

A

sex
mother to child - vertical (blood at delivery)
blood to blood

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12
Q

chronic infection of hep B

A

occurs if first exposure is in childhood

relatively uncommon

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13
Q

epidemiology of hep B

A

those born in areas of intermediate/high prevalence
multiple sexual partners
PWIDs
children of infected mothers

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14
Q

tests for hep B

A

hep B surface antigen (HBaAg+)
anti-HB
IgM - differentiates acute from chronic infection

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15
Q

what does anti-HB indicate in hep B

A

presents in immunity

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16
Q

what does hep B IgM indicate

A

presents in recently infected cases

17
Q

what does HBaAg+ indicate in hep B

A

present <6 months is chronic infection (uncommon)
high titre amount seen in highly infectious individuals
predicts risk of chronic liver disease

18
Q

clinical course of chronic hep B infection

A

immune tolerance
immune clearance
immune control
immune escape

19
Q

describe immune clearance in hep B

A

high hep B DNA level
abnormal LFTs - increased ALT
hep B antien positive

20
Q

risks of immune clearance in hep B

A

progression to;
cirrhosis >20 years
hepatocellular carcinoma > 30 years (greater the patient’s HBV DNA load, greater risk of cancer)

21
Q

immune control in hep clearnace

A

low hep B DNA level
normal LFTs
hep B antigen negative

22
Q

immune escape in hep B

A

high hep B DNA level
abnormal LFTs - increased ALT
hep B antigen negative
hep B antibody antibody postive

23
Q

risks of immune escape in hep B

A

progression to;
cirrhosis >20 years
hepatocellular carcinoma > 30 years (greater the patient’s HBV DNA load, greater risk of cancer)

24
Q

control of hep B

A 
treatment when ALT raised and high HBC DNA;
minimise exposure 
antivirals
2 pre-exposure vaccines 
post-exposure prophylaxis 
infection control
decrease alcohol intake 
hepatocellular carcinoma screening

spontaneous cure

25
Q

how is exposure minimised in hep B

A 
safe blood
safe sex
needle exchange 
prevention of meedlesticks 
screening of pregnant woman
26
Q

pre-exposure vaccines in hep B

A
  1. all children

2. adults at risk of exposure

27
Q

post exposure prophylaxis treatment in hep B

A

vaccine

hyperimune hep B immunoglobin (HBIG)

28
Q

transmission of hep C

A

similar to hep B;
sex - less easily transmitted
mother to child - vertical (blood at delivery)
blood to blood

29
Q

control of hep C

A 
treatment immediately;
anti virals 
no vaccine 
minimise exposure 
infection control
decrease alcohol intake 
hepatocellular carcinoma screening
30
Q

epidemiology of hep C

A

usually chronic infection (no spontaneous cure is seen)

most common chronic hep virus

31
Q

complications of hep A

A

acute liver failure - failure of resolution and so causes death

32
Q

clinical symptoms of hep C

A

asymptomatic until they develop chronic liver disease due to cirrhosis as a result of chronic infection

33
Q

tests for hep C

A

test hep C virus RNA by PCR

postive - active infection

34
Q

antivirals of hep B treatment

A

combination;
those ending in -vir and used in combination

mono therapy - first line;
interferon alfa

35
Q

antivirals of hep C treatment

A

interferon alpfa - first line

others include those ending in -vir and are used in combination

36
Q

describe interfon alfa

A

human protein - part of immune response to viral infection

given as pegylated interferon

37
Q

side effects of interfon alfa

A

flu-like symptoms
autoimmune disease
psychosis
thyroid disease

Gastrointestinal (71 decks)

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