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GI > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

How many different types of Viral Hepatitis exist?

A
  • 5

- Hep A, B, C, D, E

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2
Q

How is Hepatitis A spread?

A
  • Faecal-oral spread
  • More common if Poor hygiene/overcrowding
  • Some clusters of cases in MSM and PWIDs
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3
Q

People can be Hep A carriers. TRUE/FALSE?

A

FALSE

  • Hep A is always acute
  • no chronic infection
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4
Q

At what age are patients with Hep A more likely to present symptomatically?

A
  • older children / young adults

- Infants often ASYMPTOMATIC

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5
Q

How is Hep A infection confirmed in the lab?

A
  • Clotted blood for serology (gold top vacutainer)
    (same for all viral hepatitis)
  • Hepatitis A IgM
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6
Q

How is Hep A prevented?

A
  • Hygiene Control

- Vaccine prophylaxis (esp. before going to high risk country)

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7
Q

How long does it take for the Hep A vaccine to take effect?

A

10 days

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8
Q

What other subtype of Hepatitis presents in a clinically similar way to Hepatitis A?

A

Hepatitis E

  • More common in tropics
  • also faecal-oral transmission
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9
Q

Hep E is more common than Hep A in the UK. TRUE/FALSE?

A

TRUE

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10
Q

Hep E can become chronic in certain patients. Which group is most affected by this?

A
  • immunocompromised
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11
Q

Hepatitis D only co-exists with which other subtype of Hepatitis?

A

Hep B

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12
Q

Hep D exacerbates Hep B infection. TRUE/FALSE?

A

TRUE

- becomes like a super infection

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13
Q

How can Hep B be transmitted?

A
  • Sex
  • Mother to child
  • Blood to blood
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14
Q

Who is at higher risk of developing Hep B?

A
  • if born in countries of high prevalence (e.g. Africa etc)
  • Multiple sexual partners
  • People who inject drugs
  • Children of infected mother
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15
Q

What makes a patient more likely to experience chronic Hep B infection?

A
  • more likely to get chronic infection if first exposure is in childhood
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16
Q

How is Hep B infection confirmed in the lab?

A
  • Surface antigen (HBsAg) present if pt is infectious
  • HBeAg present in highly infectious individuals
  • Hep B virus DNA high titre in highly infectious individuals
  • Hep B IgM present in recently infected cases
  • Anti-HBs present in immunity
17
Q

HOw is Hep B controlled/ prevented?

A 
- Minimise exposure
=> safe blood
=> safe sex
=> needle exchange
=> screening of pregnant women
  • Post-exposure prophylaxis if exposed
    => vaccine + HepB Ig
18
Q

The transmission routes of Hep C is similar to that of Hep B. TRUE/FALSE?

A

TRUE

- it is less readily transmitted by sex than Hep B

19
Q

WHat percentage of Hep C infection becomes chronic? How long does it take for the infection to become chronic?

A

75%

- 6 months is considered chronic infection

20
Q

There is no vaccine to prevent Hep C. TRUE/FALSE?

A

TRUE

21
Q

What consequences can occur after Hep C infection and how long does this progression take?

A

Cirrhosis = >20 years

Hepatocellular carcinoma = >30 years

22
Q

How is Hep C infection tested for?

A

Test for antibody to Hepatitis C virus

If positive: Test for virus RNA by PCR

If RNA Positive => active infection
If RNA neg. => past infection

23
Q

Patients will only develop liver disease from Hep C if they have an active infection. TRUE/FALSE?

A

TRUE

- beware of PWIDs getting recurrent infections if they keep injecting

24
Q

How is acute viral hepatitis managed?

A
  • NO antivirals given
  • Monitor for encephalopathy or resolution
  • Notify Public Health
  • Immunisation of contacts
  • Test/ vaccinate against other infections if at risk
25
Q

How is CHRONIC viral hepatitis managed?

A

Antivirals

  • 12 for Hep C
  • 6 for Hep B

Vaccination

  • against other hepatitis viruses
  • if cirrhotic: influenza, pneumococcal
  • Alcohol↓ to prevent further liver damage

HCC awareness/screening

  • serum -alpha fetoprotein (AFP)
  • US
26
Q

When should you begin to treat in patients with chronic hepatitis?

A

Hep B:
- if pt has raised ALT and high Hep B DNA

Chronic Hep C:

  • Tx right away
  • If waiting list, treat advanced fibrosis or cirrhosis first
27
Q

Why is interferon alpha given in the treatment of some hepatitis?

A
  • aids the part of the body’s immune system which would normally fight off viruses
28
Q

Peginterferon injections of interferon alpha can cause what side effects?

A

Common:
- flu like symptoms: chills, sore muscles, malaise etc

Less common but more severe

  • thyroid disease
  • autoimmune disease
  • psychiatric disease

GI (33 decks)

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