Acute Hepatitis Flashcards
(29 cards)
Use the VITAMIN CDE surgical sieve to list the cuases of acute hepatitis?
VITAMIN CDE
1) Vascular = Ischaemic hepatitis (hypotension)
2) Infectious = Hep A, B, C, E, malaria, yellow fever, syphilis
3) Trauma =
- Paracetamol overdose
- alcohol abuse
4) Autoimmune
5) Metabolic
- Gall stone obstruction CBD
6) Iatrogenic
- Drugs e.g. amoxicillin
7) Neoplastic
8) Congenital
- Wilson’s disease
- haemochromatosis
9) Degenerative
- Cirrhosis
10) environement / endocrine
Who is affected by hep A virus?
children and young adults
What is the route of transmission of hep A
faecal-oral
shellfish
saliva
What is the incubation period of Hep A
2-3 weeks
What is the outcome of a hep A infection?
- cholestatic Jaundice
- DOES NOT progress to chronic hepatitis
Where is Hep B found?
Hep B is more common in africa, middle east and asia.
How is Hep B transmitted?
- blood products
- faecal-oral
- vertical (mother to child)
- sexual
What is the incubation period of Hep B?
1-5 Months (long)
Who is at risk of a Hep B infection
- men who have sex with men
- low socio-economic
- IVDU
- learning difficulties
- health workers
- prison workers
- traveller
Hep B can lead to chronic hepatitis - what are the complications of this?
- Cirrhosis
- hepatocellular carcinoma
What are the prodromal symptoms of viral hepatitis?
- fever
- malaise
- nausea
- anorexia
- arthralgia (hep B)
How is Hep C transmitted?
- mainly via blood products
- saliva
- sex
What is the incubation period of hep C?
9 weeks (long)
Who is at risk of a Hep C infection?
- haemophiliacs
- thalassaemics
- haemodialysed
- IVDU
- transplant
What % of hep C patients develop chronic hepatitis?
- 50%
What are the icteric symptoms of hepatitis?
- Jaundice
- Hepatic encephalopathy
- Pruritis
- Steatorrhea
- Dark urine
- Transient rash
Which hepatitis viruses progress to be chronic?
- Hep B
- Hep C
- Hep D
(Hep A , and Hep E not chronic)
What are the examination signs of hepatitis?
- liver flap
- Jaundice in sclera
- tenderness RUQ
- Hepatomegaly
- Splenomegaly
What investigations are done for acute hepatitis?
- LFTs
- Coagulation screen
- FBC
- U+Es
- CRP / ESR
- Coomb’s +ve haemolytic anaemia
VIRAL MARKERS:
- IgM
- Anti- HAV IgM
- HBsAg surface antigen
- HBeAg antigen
What do the LFTs in acute hepatitis show?
- raised serum bili
- raised AST
- Low ALP
- raised ALT
What does the coagulation screen show in acute hepatitis?
- Increased prothrombin time
What does the FBC show for acute hepatitis?
- raised MCV (alcohol)
- ## reduced WBC
What antibodies will be raised in acute hepatitis?
- IgM
Hep A:
- Anti-HAV Igm +ve (shows acute infection)
Hep B:
- HBsAg surface antigen
- HBeAg antigen
What hep viruses can you get vaccinated against?
Hep A and B
