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GI: liver, biliary tree and pancreas > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

what are the other infectious agenst (aside from hep A B C D E) that can cause hepatitis?

A
  • delta agent
  • EBV - this is called infective mononucleosis
  • yellow fever virus
  • CMV
  • HSV
  • toxoplasmosis
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2
Q

hepatitis ___ causes damage to cells cytopathologically - i.e. the virus kills the liver cells

A

A

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3
Q

interface hepatitis (piecemeal necrosis), portal inflammation, lobular inflammation and fibrosis are features of ____ viral hepatitis

A

chronic

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4
Q

what is interface hepatitis

A

piecemeal necrosis) is a process of inflammation and erosion of the hepatic parenchyma at its junction with portal tracts or fibrous septa

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5
Q

what is a councilman body (chronic viral hepatitis)

A

pink cells representing a dying hepatocyte surrounded by normal parenchyma

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6
Q

which liver disease shows mallory bodies?

A

alcoholic liver disease

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7
Q

There has been a decline in Hep ___due to vaccination and better housing
Hep B is now diagnosed mainly in _____ minorities who acquired it outside of the UK
Rise in Hep __ - it is now by far the most common cause of ACUTE hepatitis, since Hep __ and Hep __ present in the chronic phase and Hep __ is rare

A

There has been a decline in Hep A due to vaccination and better housing
Hep B is now diagnosed mainly in ethnic minorities who acquired it outside of the UK
Rise in Hep E - it is now by far the most common cause of acute hepatitis, since Hep C and Hep B present in the chronic phase and Hep D is rare

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8
Q

how is hep A spread?

A

faecal oral

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9
Q

how is hep B spread?

A

blood products, sexually, IVDU, mother to child

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10
Q

how is hep C spread?

A

blood products, IVDU, uncommon for sex

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11
Q

how is hep D spread?

A

blood products, sexually, IVDU, mother to child

same as B

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12
Q

how is hep E spread?

A

faecal-oral - pork

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13
Q

which are the RNA hepatitis viruses?

A

A, C, D, E

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14
Q

which are the DNA hepatitis viruses?

A

B

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15
Q

hep ___ and __ damages cells by triggering immune destrution?

A

B and C

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16
Q

what is a co-infection of hep D?

A

get them both at the same time

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17
Q

what is a super- infection of hep D?

A

hep b first then hep d

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18
Q

which hep results in chronic infection in 75% of cases

A

hep C

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19
Q

result in acute infection

A

hep A and E

20
Q

can lead to chronic infection

A

B, C, D

21
Q

which Hep have a vaccine?

A

A and B

22
Q

If infected as young children - unlikely to get symptoms.

The peak incidence of symptomatic disease in older children/young adults

A

hep A

23
Q

Chronic infection more likely if first exposure is in childhood - this is why the mother to child infection is important

Acute infection increases as age increases

A

hep B

24
Q

people who are immunocompromised might get chronic infection but usually doesnt cause chronic infection

A

Hep E

25
Q

diagnosed by IgM o virus ?

A

Hep A

26
Q

Hep B _____ present in blood of all infectious people and can indicate acute or chronic infection

A

Hep B surface antigen (HBsAg) present in blood of all infectious people

27
Q

HB _____ - usually present in highly infectious people

A

HB e Ag - usually present in highly infectious people

28
Q

Hep B _____ always also present in high titre in highly infectious people (more sensitive than ‘e’)

A

Hep B virus DNA always also present in high titre in highly infectious people (more sensitive than ‘e’)

29
Q

hep B ______ - present in immunity

A

Anti - HBsAg present in immunity

30
Q

Hep B ____ indicates more likely acute

A

Hep B IgM - more likely acute

31
Q

how is Hep C diagnosed?

A

test for Hep C antibody

32
Q

if hep C antibody present what does this indicate?

A

active or past infection

33
Q

if Hep C virus RNA negative

A

past infection

34
Q

if Hep C virus RNA positive

A

active infection

35
Q

how is Hep E diagnosed?

A

antibody to Hep E

36
Q

who gets the Hep B vaccine?

A

vaccination of at risk people (UK)

vaccination of all children / adolescents

37
Q

spontaneous cure not uncommon, even after many years of infection

A

hep B

38
Q

once chronic infection is established, spontaneous cure is not seen

A

hep C

39
Q

what is done in acute viral hepatitis?

A
  • Symptomatic
  • No antivirals given
  • Monitor for encephalopathy
  • Monitor for resolution
    of Hep B or Hep C, or Hep E if immunocompromised
  • Notify Public Health
  • Immunisation of contacts
  • Test for other infections if at risk
  • Vaccinate against other infections if at risk
40
Q

what is done in chronic viral Hep

A
  • antivirals
  • vaccination
  • alcohol down
  • hepaticellular carcinoma screening - AFP - cancer marker
41
Q

Genotype of Hep ___ V (1 to 6) important in deciding antiviral regime

A

Genotype of HCV (1 to 6) important in deciding antiviral regime

42
Q

how do you treat chronic hep B?

A

antivirals - adefovir, tenofivir, entacavir and peginterferon

43
Q

treatment for chronic hep b in HBsAg and HBe Ag positive patients and a predictin of a good cure?

A

peginterferon

44
Q

response in hep C is defined by what?

A

Response defined by loss of HCV RNA in blood sustained to 6 months after end of therapy

  • virological cure
  • known as Sustained Virological Response or SVR
  • relapse after SVR is rare
  • reinfection can occur
45
Q

antivirals used for all genotypes of hep C

A

peginterferon and ribavirin

46
Q

antivirals used for onyl genotype 1 of hep C

A

Telaprevir and Boceprevir

GI: liver, biliary tree and pancreas (20 decks)

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