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GASTROENTEROLOGY > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

Acute Infection:

Causes - 3

Transmission

A

Hep A, B and E

Faecal-oral transmission - food, water and sexual

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2
Q

Chronic infection:

Causes - 2

Which virus can Hep D co-infect with?

A

Hep B and C

Hep B

Hep B can be both acute and chronic

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3
Q

Chronic infection:

A common route of transmission for Hep C?

Which virus has a vertical (mother-to-child) route of transmission?

Which virus can be contracted via contact of broken skin or mucosa?

Other routes of transmission?

A

IVDU

Hep B

Hep B

Sex
Needlestick injury for HIV, Hep B and C
Blood products
Unhygienic piercings and tattoos

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4
Q

HBV natural history:

What happens when contracted during childhood?

When does it reappear, why and how?

A

It is asymptomatic through childhood with normal LFT

20’s

Acute hepatitis

Immune system attempts to clear the infection

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5
Q

S+S - acute hepatitis (HAV, HAB and HEB):

Prodrome symptoms

Main symptoms are peak

How long does it take to resolve?

A

Fever
Malaise
Anorexia
Nausea

Jaundice
Pale stool and dark urine 
Itch 
RUQ pain 
Hepato/splenomegaly 
Lymphadenopathy

2-6 wks

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6
Q

HBV natural history:

What happens when contracted during childhood?

When does it reappear, why and how?

A

It is asymptomatic through childhood with normal LFT

20’s

Acute hepatitis

Immune system attempts to clear the infection

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7
Q

HCV:

What is one key feature of this one?

A

Most patients become chronically infected

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8
Q

DDx - other viruses that could cause infection?

A

EBV
CMV
HSV
Yellow fever

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9
Q

Non-infectious hepatitis causes - list a few

A 
Obesity and alcohol - NASH, alcoholic hepatitis 
Autoimmune hepatitis 
Drugs 
Ischaemic hepatitis 
Wilson's
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10
Q

Blood tests for:

HAV
HBV
HCV
HEV

A

HAV IgM - immunoglobulin

HAB Ag - antigen

HCV Ab - antibodies

HEV IgM - immunoglobulins

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11
Q

HBV:

Transmission - 3

At-risk groups

A

Blood
IVDU
Direct contact

IVDU
Health workers 
Haemophilliacs
Homosexuals 
Dialysis
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12
Q

HAV:

Transmission - 1

What type of fish can you also get it from?

A

Faecal-oral

Shellfish

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13
Q

HCV:

Transmission - 3

What does it increase the risk of as it is chronic?

A

Transfusion
IVDU
Sexual contact

HCC

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14
Q

HDV:

What is needed for it to infect?

How is it prevented?

A

HBV

HBV vaccine

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15
Q

HEV:

What person has a high mortality if they contract this virus?

A

Pregnant women

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16
Q

Management:

Who should be notified once infected?

What should happen to contacts?

A

Public Health England

Screen and vaccinate contacts (HAV and HBV)

17
Q

Management - Acute infection:

What should be avoided?

What should be given if ALF happens in acute HBV?

A

Alcohol

Antiviral medication

18
Q

Management - Chronic infection:

How can transmission be prevented? - 2

What lifestyle advice should be given to prevent HCV progression?

What can be done every 2 years to detect cirrhosis?

What should be screened every 6 months with USS?

What should be monitored every 3 yrs using endoscopy?

A

Avoiding unprotected sex
Toothbrush sharing

IVDU
Alcohol use
Obesity
HIV co-infection

FibreScan

HCC

Varices

19
Q

Complications - acute:

What increases the risk of ALF?

What might happen to the kidneys with HBV?

A

Hep D co-infection

Glomerulonephritis

20
Q

Vaccination:

Which 2 viruses have vaccines?

A

Hep A and B

21
Q

Hep A vaccine:

How long before exposure should it be given?

When should it be repeated once exposed for 10 yr protection?

Indications - list

A

2-4 wks

6-12 months

Sexual and household contacts 
Foreign travellers 
Men who have sex with men 
Haemophiliacs 
IVDU
22
Q

Hep B vaccine:

3 doses are given. When though?

How long does protection last?

Indications - list

How long can you get post-exposure prophylaxis for?

A

Today, 1 month and 6 months

Lifelong

Sexual and household contacts
Children of affected mothers
Men who have sex with men
HIV + individuals

48 hrs

GASTROENTEROLOGY (54 decks)

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