viral hepatits

Question 1

which is the acute hepatitis

Answer 1

A

Question 2

which hepatitis is dna not rna based

Answer 2

B

Question 3

what are the markers for HAV

Answer 3

IgM

Question 4

what are the markers for HEV

Answer 4

IgM and IgG

Question 5

what are the markers for HCV

Answer 5

anti-HCV

HCV RNA

Question 6

what are the markers for HBV

Answer 6

IgM
HBsAG
HBeAG
HBeAB
HBV DNA

Question 7

which hepatitis is infectious and how is it passed

Answer 7

A

faeces and saliva

Question 8

which hepatitis are transmitted by bodily fluids and which route is most common for each

Answer 8

B=vertical transmission
D
C (mostly blood)- IVDU, tattoo or in past transfusion

Question 9

which hepatitis is enterically transmitted and how

Answer 9

E by faeces

Question 10

Why is HAV not chronic

Answer 10

develop protective antibodies that are life long

Question 11

clinical features of hav

Answer 11

jaundice
pale stools
dark urine
fever
malaise
abdominal pain
nausea

Question 12

what are the complications of HAV

Answer 12

1. fulminant heapitis- acute liver failure can lead to death 50%, hepatic enpheolpathy and necrosis leading to transplant need
2. cholestatic hepatitis obstruction of bile secretion and dysfunction of bile canaliculi= high bilirubin levels persist for months and relapsing hepatitis

Question 13

incubation period for HAV

Answer 13

average 30 days

range 15-50 days

Question 14

diagnosis of HAV

Answer 14

acute phase infection
IgM anti HAV
ast and alt

Question 15

course of HAV

Answer 15

• replicates in liver
• peak infectivity 2 weeks prior to onset jaundice
• children shed HAV for longer
• hav in stools
• viremia occurs soon after infection

Question 16

incubation period hev

Answer 16

average 40 days

range 15-60 days

Question 17

who are most likely to develop chronic HEV

Answer 17

immunosuppressed people otherwise usually acute

Question 18

foods high in HEV

Answer 18

mussels west coast scotland

Question 19

diagnosis of HEV

Answer 19

IgM and IgG HEV
pcr positive
immunocompromised
high alt

Question 20

prognosis of chronic infection and cirrhosis from hev

Answer 20

chronic=60%

cirrhosis=10%

Question 21

treatment for hev

Answer 21

ribavirin (immunocompetent

- interferon and ribavirin for chronic HEV for 3 months

Question 22

what family does HCV belong to

Answer 22

flaviviridae family

Question 23

how many genotypes of hcv are there

Answer 23

6

Question 24

most common genotype in uk

Answer 24

1 followed by 2

Question 25

symptoms HCV

Answer 25

icterus (jaundice)

Question 26

complications cirrhosis HCV

Answer 26

Oseophageal varices
cirrhosis complications
HCC

Question 27

treatment of HCV

Answer 27

pegylated interferon and ribavirin together
or now also have
=DAA’S that can be taken with them or on its own

Question 28

adverse effects of ribavirin

Answer 28

haemolytic anaemia

Question 29

adverse effects of interferon

Answer 29

myalgia
fatigue
injection site reaction
dry skin
neutropaenia
thrombocytopaenia

Question 30

most common way of transmittin hep c

Answer 30

IVDU
tattoo
transfusion
ie blood to blood

Question 31

how often should people with hep c be surveillance for hcc

Answer 31

AFP and USS every 6months

Question 32

symptoms of acute hepaitits C

Answer 32

jaundice

the more symptomatic the better

Question 33

4 classes of DAA

Answer 33

N3/N4A protease inhibitors

Question 34

most common way of transmitting each

Answer 34

hav=faeces and saliva
hbv= vertical 90%
hcv=blood ivdu..
hev=faeces