viral hepatitis pt 1

Question 1

which liver enzymes takes the longest to return to normal ?

Answer 1

ALT

Question 2

what type of jaundice is associated with viral hepatitis ?

Answer 2

hepatocellular jaundice
rise in both conjugated and unconjugated bilirubin

Question 3

what is the best screening test for hepatitis C virus ?

Answer 3

ELISA

Question 4

what is the best pretreatment predictor of response?

Answer 4

testing for the virus genotype

Question 5

what is the primary goal of therapy in HCV therapy ?

Answer 5

cure of HCV infection (SVR 12 or SVR24 ) after end of treatment ( EOT )
SVR : sustained virologic response

Question 6

what is the screening strategy for chronic HCV ?

Answer 6

Anti-HCV Ab testing
if positive
then proceed with HCV RNA testing

Question 7

how should fibrosis be assessed in cirrhotic patients?

Answer 7

Multi-phasic CT , where there is hyper-enhancement in the arterial phase and then washout in the venous phase

Question 8

what score is used to grade fibrosis ?

Answer 8

METAVIR

Question 9

which patients need post treatment surveillance for HCC ?

Answer 9

patients with METAVIR score F3 or beyond

Question 10

which HCV patients should be treated without delay?

Answer 10

all patient should be considered for treatment especially if :
1- got HCV after liver transplantation
2- women of childbearing age wishing to get pregnant
3- people who inject drugs
4- MSM high risk sexual behaviour
5- haemodialysis patients
6- individuals at risk of transmitting HCV

Question 11

what are examples of Direct Acting Anti-virals ?

Answer 11

sofosbuvir

Question 12

what are the methods of spread of each type of hepatitis causing virus ?

Answer 12

Hep A - feco-oral through food and water
Hep B - through blood
Hep C - through blood
Hep D - only comes if there is hep B ( either coinfection or superinfection )
Hep E - through contaminated water especially cont fish ( dangerous in pregnancy )