Viral Hepatitis Flashcards

1
Q

Acute

Chronic

A

Acute - A and E

Chronic - B, C and D

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2
Q

What hepatitis is transmitted via facael-oral route?

A

A

E

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3
Q

When would you bring a patient into hospital with acute viral hepatitis?

A

Vomiting/change of mental state/confused/drowsy - encelopathy

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4
Q

How would you know if a patient had a current infection of HepA or had been previously infected?

A

IgM - presence of infection
IgG - vaccine/ previous infection

(HepA = antibodies)

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5
Q

What is really important to ask if suspectected viral hepatitis?

A

Pregnancy - increases mortality

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6
Q

How to diagnose HepE?

A

HEV RNA in stool/blood

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7
Q

How is HepB (and HepC) transmitted?

A

Three B’s
B - boner
B - baby
B - blood

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8
Q

Who’s more at risk of HepB chronic infection, children or adults?

A

Children who catch it from infected mums

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9
Q

What is present in all HepB infectious individuals?

A

HBsAg

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10
Q

What is used to measure response to antiviral therapy in HepB?

A

HBV DNA

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11
Q

What HepB IgM high or low titre mean?

A
High = acute
Low = chronic
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12
Q

Antivirals cure HepB. True/False?

A

False - only suppress

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13
Q

First test for HepC?

Followed by?

A

If HCV IgG positive (means have/had infection)

HCV-RNA (via PCR) - positive = active infection
negative = previous infection

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14
Q

When do you treat chronic viral hepatitis?

A

HepB = raised ALT or high HBV DNA

HepC = straight away (no chance of spontaneous remision)

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15
Q

When hepatocytes undergo cytotoxic killing/apoptosis what is produced?

A

Eosinophilic councilman bodies

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16
Q

Once diagnosed with viral hepatitis, who must be notified?

A

Public health

17
Q

How many years before chronic hepatitis will progress to: a) cirrhosis b) hepatocellular carcinoma

A

Cirrhosis - 20 years

Carcinoma - 30 years

18
Q

What is the difference between confection and superinfection of HepD and what other virus is it associated with?

A

Coinfection - infected at same time as HepB
Superinfection - infected sometime after being infected with HepB (worse)

HepB

19
Q

What effect does HepD have?

A

Worsens HepB infection

20
Q

What viral hepatitis is the most common cause of liver transplant in the UK?

A

HepC

21
Q

What is SVR?

A

Sustained virological response - loss of HVC RNA for 6mnths+

22
Q

What viral hepatitis can be vaccinated against? Which one would be given to patients about to travel to a tropical country?

A

A - given if travelling (and heamophiliac or chronic liver disease)
B - (given to all newborns >2017)
E - but not used in UK

23
Q

All viral hepatitis are RNA viruses apart from one which is DNA, which one is it?

A

HepB is DNA virus

think HepB associated with HepD D=DNA

24
Q

What hepatitis is associated with pigs, deer and rabbits?

A

HepE

25
Q

How do you treat acute viral hepatitis?

A

Majority are self-limiting

If immunosuppressed monitor as can progress to chronic in HepE

26
Q

A rash is most commonly associated with what type of hepatitis?

A

HepB

27
Q

What type of hepatitis has the ability to spontaneous cure itself?

A
Hep B
(HepC will never cure itself without intervention)
28
Q

When would you test for anti-HDV antibodies?

A

If HBsAg positive (if have HepB)

29
Q

What counts as cured for HepB?

A

Loss of HBsAG/ anti-HBsAg IgG

30
Q

What consitutes chronic hepatitis?

A

Hepatits >6mnths

31
Q

What will be present in individuals with acute HepB infection?

A

HBeAg

32
Q

What chronic hepatitis is treated straight away and how is it treated?

A

HepC

Protease inhibitors - antivirals for 12 weeks until SVR obtained

33
Q

When is a patient with HepB qualify for treatment and what treatment will they receive?

A

High levels of ALT and HVB DNA

  1. Peginterferon alfa-2a (injection)
  2. Antivirals (Entecavir)
34
Q

HbsAb positive?

A

Had vaccine for HepB

Recovered/immune

35
Q

What kind of jaundice is associated with viral hepatitis?

A

Conjugated due to hepatocytes dying and releasing CB