viral hepatitis

Question 1

what are the different types of hepatitis?

Answer 1

Hep A,B,C,D,E

Question 2

How is hep A transmitted?

Answer 2

faecal oral route

Question 3

incubation time for Hep A?

Answer 3

SHORT (2-4 weeks)

Question 4

prognosis for Hep A?

Answer 4

Acute, self-limiting illness. Does not cause chronic infection.

Question 5

symptoms of Hep A?

Answer 5

fatigue, RUQ pain, tender hepatomegaly, raised LFTs

Question 6

is there a vaccination for Hep A and who gets it?

Answer 6

yes, given to people at risk, e.g. going to Africa

Question 7

hep _ is a RNA picovirus?

Answer 7

Hep A is an RNA picovirus

Question 8

hep _ is a double stranded hepadenovirus?

Answer 8

hep B is a double stranded hepadenovirus

Question 9

how is hep B spread?

Answer 9

body fluids (blood, saliva), vertical transmission (mother to child), sexuual transmission

Question 10

Hep B incubation period?

Answer 10

LONG (6-20 weeks) can become chronic

Question 11

is there a vaccination for Hep B and who gets it?

Answer 11

everyone is vaccinated at birth against Hep B

Question 12

hep _ is and RNA flavivirus?

Answer 12

Hep C

Question 13

how is hep C transmitted?

Answer 13

contaminated blood products (IV drug abuse, tattoos, mother to child), sex (5%)

Question 14

risk factors for Hep C?

Answer 14

IV drug use
blood transfusion (haemophiliacs) before 1991
unprotected sex (5%)
vertical transmission (6%)

Question 15

most people infected with hep C have symptoms

Answer 15

False, only 30% of people present with vague symptoms. Most people are asymptomatic.

Question 16

prognosis of Hep C?

Answer 16

15% clear the virus

85% end up with chronic infection

Question 17

complications of hep C?

Answer 17

hepatocellular carcinoma
cryoglobulinemia
glomerulonephritis
polyarteritis nodosa

Question 18

what is the histological finding of chronic hepatitis?

Answer 18

ground glass appearance under light microscopy

Question 19

define chronic hep C?

Answer 19

presence of HVC in the blood for >6 months

Question 20

treatment for Hep C?

Answer 20

protease inhibitors

Question 21

hep _ is a single strand (incomplete) RNA virus?

Answer 21

Hep D

Question 22

which two forms of Hep are usually found together?

Answer 22

Hep B and Hep D. Hep D needs the parent strand of Hep B surface antigen to complete its replication and transmission cycle.

Question 23

how is hep D transmitted

Answer 23

parenterally, usually co-exists with Hep B

Question 24

what is Hep D superinfection?

Answer 24

when a Hep B+ person goes on to develop hep D

Question 25

hep D is associated with fulminant hepatitis, what is this?

Answer 25

acute liver disease: jaundice, ascites, coagulopathy, encephalopathy

Question 26

Hep _ is an RNA herpevirus

Answer 26

Hep E

Question 27

how is Hep E spread?

Answer 27

fecal oral route from small animals (zoonosis) [alfiE] incubation 3-8 weeks significant mortality if infected in pregnancy

Question 28

is there a vaccine against hep E

Answer 28

no

Question 29

where is Hep A most likely to spread?

Answer 29

MSMs, over-crowding, IV drug use

Question 30

investigations for Hep A?

Answer 30

raised LFTs, Hep A IgM (acute infection)

Question 31

treatment for Hep D?

Answer 31

IFN (peginterferon) injection

Question 32

treatment for Hep B?

Answer 32

IFN (peginterferon) injection

Question 33

main side-effect of IFN (peginterferon) injection?

Answer 33

flu-like illness

Question 34

pathological finding of chronic hepatitis?

Answer 34

Councilman body (hepatocyte apoptosis)

Question 35

what is the most common cause of and features of acute liver failure (fulminant hepatitis)?

Answer 35

most common cause: malignancy or paracetamol OD (NAQPI build up) encephalopathy, jaundice, lethargy, itch, N&V, coagulopathy, tender hepatosplenomegaly

Question 36

what are the two types of autoimmune hepatitis (AIH)?

Answer 36

type 1: affects adults and children (ANA/ASMA antibodies) | type2: only affects children (LKM1 antibodies)

Question 37

investigation for autoimmune hepatitis?

Answer 37

liver biopsy - will shoe 'piecemeal necrosis'

Question 38

treatment for autoimmune hepatitis?

Answer 38

induce remission with steroids maintain remission with azathioprine (daily) continue treatment for 2-3 years or life long. Azathioprine is safe in pregnancy.

Question 39

chronic liver disease is defines as >__months?

Answer 39

>6 months

Question 40

go over Hep B serology!!

Answer 40

SEMA

Question 41

differentials for a young person presenting with acute hepatitis?

Answer 41

drugs (paracetamol), AIH, viral hep