Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

Hepatitis A - Transmission

A

Faecal-oral
Poor hygiene/overcrowding
Some imported cases
Clusters = gay men, injecting drug users

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hepatitis A - Clinical

A

Acute hepatitis, no chronic infection
Peak incidence of symptomatic disease in children/younger adults
Usually ill for a few weeks then get better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hepatitis A - Lab Conformation fo Acute Infection

A

Clotted blood for serology

Hepatitis A IgM (usually detectable from onset of disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hepatitis A - Control

A

Hygiene

Vaccine prophylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hepatitis E - Clinical

A

Acute hepatitis, no chronic infection
Peak incidence of symptomatic disease in children/younger adults
Usually ill for a few weeks then get better
Some immunocompromised humans can become chronically infected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Hepatitis E - Incidence

A

More common in tropics

Has become more common than Hep A in UK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Hepatitis E - Transmission

A

Faecal-oral

UK cases are thought to be through zoonoses (esp. pigs, deer and rabbits)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hepatitis E - Tropical Genotypes

A

In pregnant women, causes severe disease and likely death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hepatitis E - Control

A

No vaccine available yet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hepatitis D - Incidence

A

Can only infect those with Hep B

Exacerbates Hep B infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hepatitis D - Co Infection

A

Have Hep B and Hep D at the same time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hepatitis D - Superinfection

A

Have Hep B, then go on to develop Hep D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Hepatitis B - Transmission

A

Sex
Mother to child
Blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hepatitis B - Higher Risk

A

People born in intermediate/high prevalence areas
Multiple sex partners
People who inject drugs
Children of infected mothers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hepatitis B - HBsAg

A

Hepatitis B Surface Antigen
Present in the blood of all infected individuals
Chronic infection = present for >6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hepatitis B - Clinical

A

Risk of chronic infection decreases with increasing age of exposure
Risk of acute hepatitis increases with age at exposure
Death is more likely to result from a chronic infection than an acute infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hepatitis B - HBeAG

A

Hepatitis B e Antigen

Usually present in highly infectious individuals

18
Q

Hepatitis B - Hep B DNA

A

Always present in highly infectious individuals
Used to predict risk of chronic liver disease and monitor therapy
More sensitive than HBeAG

19
Q

Hepatitis B - Hep B IgM

A

Most likely to be present in recently infected cases

20
Q

Hepatitis B - Control

A 
Safe blood
Safe sex
Needle exchange 
Prevention of needlesticks 
Screening of pregnant women
Pre-exposure vaccination 
Post-exposure prophylaxis (vaccine + HBIG)
21
Q

Hepatitis C - Transmission

A

Less easily transmitted by sex than Hep B
Mother to child
Blood

22
Q

Hepatitis C - Clinical

A

75% of cases result in chronic infection

Natural history not dependent on age at time of infection

23
Q

Hepatitis C - Lab Conformation

A 
Test for antibody to Hep C 
\+ve = Past or active infection 
-ve = Not infected 
Test for Hep C RNA by PCR 
\+ve = Active infection 
-ve = Past infection
24
Q

Hepatitis C - Control

A

No vaccine

Must minimise exposure

25
Q

Hepatitis A - Natural History

A

Infection
Mostly asymptomatic/acute hepatitis -> resolution
Rarely (e.g. elderly) acute liver failure -> death or resolution

26
Q

Natural History of Chronic Infection - Hep B

A

Spontaneous cure not uncommon, eve after many years of infection

27
Q

Natural History of Chronic Infection - Hep C

A

Once chronic infection is established, spontaneous cure is not seen

28
Q

Hepatitis C - Natural History

A

Infection
Mostly asymptomatic -> chronic infection -> chronic hepatitis -> cirrhosis -> chronic liver failure/cancer -> death
25% resolution from asymptomatic disease

29
Q

Hepatitis B - Natural History, Adult Infection

A

Infection
Most asymptomatic/acute hepatitis -> resolution
Less than 5% develop chronic infection/chronic hepatitis (some of these cases still resolve)
Few result in cirrhosis -> chronic liver failure/cancer -> death

30
Q

Hepatitis B - Natural History, Infection at Birth

A

Similar to Hep C

high levels of chronic infection and complications

31
Q

Management of Acute Viral Hepatitis

A 
Symptomatic 
No antivirals given 
Monitor for encephalopathy 
Monitor for resolution 
Notify Public Health 
Immunise contacts 
Test/vaccinate for other at risk infections
32
Q

Management of Chronic Viral Hepatitis

A 
Antivirals 
Vaccination 
Infection control 
Decrease alcohol intake 
Hepatocellular carcinoma awareness/screening
33
Q

Antiviral Treatment - Who?

A

Chronic infection
Risk of complications = inflammation present
Fit for treatment = liver cancer contraindicates, cirrhosis and HIV make treatment more difficult
Patient issues = side effects, lifestyle issues, attitude to treatment

34
Q

Antiviral Treatment - When?

A

Before complications
Evidence of inflammation
Patient is ready
Clinical priority (e.g. HIV may be treated an controlled first)

35
Q

Antiviral Treatment - Interferon Alpha

A

Human protein
Injected
Genetically engineered

36
Q

Antiviral Treatment - Interferon Alpha - Side Effects

A 
Common = 
Flu like 
Chills 
Sore muscles 
Malaise

Rarer but severe =
Thyroid disease
Autoimmune disease
Psychiatric disease

37
Q

Therapy for Chronic Hepatitis B

A

Option 1
Interferon only
Sustained cure possible, but only minority gain benefit and serious side effects

Option 2
Suppressive antiviral drug
Safer, but only suppression so no cure and possible resistance

38
Q

Aims of Chronic Hepatitis B Therapy

A 
Reduce HBV DNA, lose HBeAg, lose HBsAg
Improve liver biochemistry 
Improve histopathology 
Reduce infectivity 
Reduce progression 
Reduce mortality
39
Q

Aims of Chronic Hepatitis C Therapy

A 
Response defied by loss of HCV RNA in blood sustained 6 moths after therapy (aka SVR)
Improve liver biochemistry 
Improve histopathology 
Reduce infectivity 
Reduce progression 
Reduce mortality
40
Q

Principles of Hepatitis C Therapy

A 
Choice of antiviral based on = 
Genotype of virus, viral load 
Genotype of patient's interferon response genes 
Stage of disease
Past treatment experience 
Likelihood of side effects 
Cost effectiveness
41
Q

Hepatitis C Therapy - Newer Antivirals

A

Simeprevir, Ledipasvir, Daclatasvir =
Used in certain genotypes in combo with other drugs
Safe and well tolerated

Sofosbuvir =
Active against all genotypes in combo with other drugs
Safe and well tolerated

GI (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions