VIRAL HEPATITIS

Question 1

What is Hepatitis A?

Answer 1

Inflammation of the liver caused by a RNA virus with a faecal-oral spread

Question 2

What are the symptoms of Hepatitis A?

Answer 2

Fatigue
Sudden nausea and vomiting
Clay-coloured bowel
Loss of appetite
Low-grade fever
Dark urine

Question 3

What are the signs of hepatitis A?

Answer 3

Hepatomegaly
RUQ pain
Joint pain
Jaundice
Pruritus

Question 4

What are risk factors of Hepatitis A?

Answer 4

Endemic area

Close personal contact with infected person

Men-to-men sex

Childcare workers

IV illegal drugs users

Question 5

How is Hepatitis A investigated?

Answer 5

LFT: high AST, ALT, and Bilirubin

IgM/IgG anti-HAV: positive

U&E: renal failure

Question 6

How is HAV treated?

Answer 6

With plenty of fluids, abstaining from sex, alcohol and maintaining good hygiene

HAV resolves itself after 6months

Question 7

Which virus does HEV present like?

Answer 7

HAV

Question 8

What is HBV?

Answer 8

A serious infection caused by DNA virus sexually and vertically transmitted

Question 9

What is the symptoms of HBV?

Answer 9

Usually Asymptomatic

Fatigue
Sudden Nausea and vomiting 
Loss of appetite
Low-grade fever
Dark urine
Clay-coloured stools

Question 10

What are the signs of HBV?

Answer 10

Hepatomegaly 
RUQ pain
Jaundice
Splenomegaly
Pruritus
Joint pain

Question 11

What are the risk factors of HBV?

Answer 11

Antenatal exposure
Multiple sexual partners
Men-to-men sex
IV drug users
Family History of HBV 
Travel to endemic region

Question 12

Which blood tests would you do for HBV?

Answer 12

LFT: high AST, ALT, ASP, Bilirubin; low Albumin

U&E: hyponatraemia, high urea

HBV DNA/SURFACE ANTIGENS: positive

Question 13

What do the different HBV antigens mean?

Answer 13

HBsAg: surface antigen present 1-6months after exposure

HBeAg: DNA antigen indicates high infectivity

ab-HBcAg: implies past infection

ab-HBsAg: implies vaccination

Question 14

What is the indication of chronic HBV?

Answer 14

HBsAg lasting more than 6months

Question 15

How is acute HBV managed?

Answer 15

It resolves itself

Interferon may be prescribed to boast immune system

Question 16

How is chronic HBV treated?

Answer 16

Antiviral therapy - entecavir or tenofovir disoproxil

Question 17

What is HCV?

Answer 17

A RNA flavivirus transmitted by blood, that causes liver inflammation and leads to serious liver damage

Question 18

What are the symptoms of HCV?

Answer 18

Easy Bleeding and bruising
Fatigue
Sudden nausea and vomiting
Loss of appetite
Dark urine
Pruritus

Question 19

What are the signs of HCV?

Answer 19

Hepatomegaly 
Splenomegaly 
RUQ pain
Joint pain
Ascites

Question 20

What are common risk factors of HCV?

Answer 20

Unsafe medical practice

IV or intranasal drug users

History of blood transfusion or organ transplant

Question 21

What are the blood tests to investigate HCV?

Answer 21

LFT - high ALP, high ALT and AST

ANTI-HCV AB: positive - current or past infection

HCV-PCR: positive - current infection

Question 22

How is HCV managed?

Answer 22

Ribavirin (antiviral therapy for 24-48weeks)

Interferon is given to boast immune system

Question 23

Which viral hepatitis lead to chronic hepatitis?

Answer 23

B and C

Question 24

Which Viral Hepatitis is associated with Hepatitis B?

Answer 24

Hepatitis Delta (D)