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Clinical Alimentary System > 3.13.2. Liver + Biliary Tree Disease - Viral Hepatitis - B > Flashcards

3.13.2. Liver + Biliary Tree Disease - Viral Hepatitis - B Flashcards

1
Q

What causes Hepatitis B infection?

A

A Parenteral Virus (HBV)

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2
Q

How does HBV enter into the Bloodstream?

A

It is a Parenternal Virus -

Transmitted through Blood-Blood contact

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3
Q

How are most Blood-Blood (Parenternal) Viruses transmitted?

A
  1. I.V. Drug Abusers

2. Sex

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4
Q

What type of disease does HBV cause?

A

Chronic Liver Disease

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5
Q

What is the Structure of the Hepatitis B Virus?

A
  1. HBV DNA and DNA Polymerase are contained within an Inner Protein Core (HBcAg)
  2. The Inner Protein Core is contained within an Outer Lipid Envelope, containing the Surface Antigen (HBsAg)
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6
Q

What happens during Active Replication of the Hepatitis B Virus?

A

The Inner Protein Core (HBcAg) changes into the Hepatitis E Antigen (HBeAg)

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7
Q

What is the significance of HBcAg changing into the Hepatitis E Antigen (HBeAg) during Active Replication?

A

The Hepatitis E Antigen (HBeAg) can be measured in the Blood, with Hepatitis B Viral Infection

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8
Q

What are the Antibodies, produced by the Body, in response to a Hepatitis B infection?

A
  1. Anti-HBs
  2. IgM Anti-HBc
  3. IgG Anti-HBc
  4. Anti-HBe
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9
Q

What does Anti-HBs act against? And what purpose does it have?

A

This acts against the Surface Antigen of the Hepatitis B Virus (HBsAg), for Protection

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10
Q

What does IgM Anti-HBc act against? And what purpose does it have?

A

This acts against the Inner Protein Core of the Hepatitis B Virus (HBcAg), in acute infection

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11
Q

What does IgG Anti-HBc act against? And what purpose does it have?

A

This acts against the Inner Protein Core of the Hepatitis B Virus (HBcAg), in chronic infection

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12
Q

What does Anti-HBe act against? And what purpose does it have?

A

This acts against the Hepatitis E Antigen (HBeAg), present when there is active replication - it is an anti-virus

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13
Q

What does acute infection with HBV cause?

A

Inflammation of the Liver

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14
Q

What does chronic infection with HBV cause?

A
  1. No further development (in 60-85% of cases)
  2. Progression to Liver Fibrosis / Cirrhosis
  3. Progression from 1 or 2 to Hepatocellular Carcinoma
  4. Progression from 2 or 3 to End-Stage Liver Disease
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15
Q

What are the Clinical Signs of HBV infection?

A
  1. Hepatomegaly
  2. Lymphadenopathy
  3. Deranged Enzymes
  4. Jaundice
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16
Q

Why does Hepatomegaly occur?

A

Due to the Inflammation of the Liver caused by the HBV infection

17
Q

Why does Lymphadenopathy occur?

A

This is due to the Immune response to the HBV infection

18
Q

Why do Deranged Enzymes appear?

A

Due to the potential impairment of the Hepatic Function

19
Q

What type of Jaundice occurs?

A

Intrahepatic

20
Q

Why does Jaundice occur?

A

Due to the damage of Hepatocytes, they cannot effectively deal with Bilirubin and so there is a back-up into the Blood

21
Q

What are the Symptoms of HBV infection?

A
  1. Nausea and Vomiting

2. Anorexia

22
Q

Why does Nausea and Vomiting occur in an HBV infection?

A

Due to this being an infection of an Accessory Organ of the Alimenatry Tract, this is the body’s natural response

23
Q

Why does Anorexia occur?

A

Due to the associated Nausea and Vomiting

24
Q

What investigations are necessary for HBV infection?

A
  1. Blood Inflammatory Markers (PCR and ESR)

2. Serum ELISA looking for the HBsAg (Hepatitis B Surface Antigen)

25
Q

What is the course of action id the HBsAg is negative?

A

There is no active infection, so the Vaccine Series is Initiated or Completed

26
Q

What is shown if the HBsAg is positive?

A

There is Chronic or Active Infection

27
Q

What is the course of action if the HBsAg is positive with Clinical Evidence of Infection?

A

There is a Serum ELISA for IgM Anti-HBc:

  1. If this is positive there is Active infection present
  2. If this is negative there is Chronic infection present
28
Q

What is the course of action if the HBsAg is positive without Clinical Evidence of Infection?

A

There is Chronic Infection present, so there is Evaluation for ongoing monitoring and treatment

29
Q

What is the course of action if the HBsAg is positive, and the IgM Anti-HBc is negative?

A

There is Chronic Infection present, so there is Evaluation for ongoing monitoring and treatment

30
Q

What is the shown if the HBsAg is positive, and the IgM Anti-HBc is positive?

A

There is acute infection

31
Q

What is the treatment for HBV infection?

A

Lamivudine

32
Q

What is Lamivudine?

A

An antiviral which inhibits HBV reverse transcriptase, safely suppressing HBV replication during long-term use

33
Q

What can advanced stage HBV lead to?

A

Liver Cirrhosis

Clinical Alimentary System (64 decks)

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