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Flashcards in Acute Hepatitis Deck (25)
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1

What type of virus is hepatitis A and how is it transmitted?

it is an RNA virus

 

it is transmitted via the faecal-oral route

 

this is usually via contaminated food 

2

What are the risk factors for hepatitis A infection?

 

What are its specific features?

  • travelling (e.g. Africa / Asia)

 

  • contaminated food and/or water

 

  • it commonly has an acute presentation

3

What type of virus is hepatitis B?

 

How is it transmitted?

it is a DNA virus

 

it can be transmitted parentally, sexually or vertically

 

parenteral transmission means that it is transmitted by any mechanism outside of the alimentary canal

 

e.g. subcutaneous, intravenously, intramuscularly 

4

What are the risk factors and specific features for hepatitis B?

  • bodily fluids and contaminated blood (e.g. IVDU)

 

  • it is commonly an acute presentation

5

What type of virus is hepatitis C?

 

How is it transmitted?

it is an RNA virus

 

transmission is mainly parenteral

6

What are the risk factors for hepatitis C infection?

 

What are its specific features?

  • contaminated blood (e.g. IVDU)

 

  • this infection is usually asymptomatic and chronic

7

What type of virus is hepatitis D and how is it transmitted?

it is an RNA virus

 

it is transmitted parentally or sexually

8

What are the risk factors and specific features of hepatitis D?

  • bodily fluids and contaminated blood

 

  • it only co-infects with hepatitis B 

 

if you are negative for hepatits b, then you cannot get hepatitis d

9

What type of virus is hepatitis E and how is it transmitted?

it is an RNA virus

 

it is transmitted via the faecal-oral route 

10

What are the risk factors and specific features for hepatitis E?

  • contaminated food and/or water

 

  • it has a very high mortality with pregnant women

11

What are the symptoms of viral hepatitis?

  • RUQ pain

 

  • pruritis 

 

  • nausea and/or vomiting

 

  • anorexia

 

  • joint pain

12

What are the clinical signs of viral hepatitis?

  • RUQ tenderness

 

  • jaundice

13

What blood tests are done when viral hepatitis is suspected?

  • Liver function tests (LFTs)
    • raised AST and ALT > 1000 IU/L
    • low albumin

 

  • prothrombin time will be raised

 

  • serology is performed to identify specific antibodies 

 

  • acute damage to the liver is shown through high bilirubin, low albumin and prolonged PTT

14

What is looked for when performing hepatitis B serology?

  • HBsAg is a marker of active infection

 

  • HBsAb is a marker of immunity 
    • this indicates the person has had an infection in the past 

 

  • Anti-HBc IgM (core IgM) indicates there is an acute infection

 

  • Anti-HBc IgG (core IgG) indicates a PAST acute infection

15

When performing hepatitis B serology, what does the presence of HBeAg and HBV DNA suggest?

  • HBeAg suggests active replication indicating infectiousness

 

  • HBV DNA suggests active replication and is used to monitor response to treatment

16

What are the 3 most important risk factors for chronic liver disease (cirrhosis)?

  • alcohol

 

  • hepatitis B and C

 

  • obesity / non-alcoholic fatty liver disease

17

What are less common risk factors for chronic liver disease / cirrhosis?

  • autoimmunity in the liver and biliary tract
    • e.g. PSC / PBC

 

  • genetic conditions
    • Wilson's disease
    • haemochromatosis
    • cystic fibrosis
    • alpha-1 antitrypsin deficiency

18

What are the symptoms of chronic liver disease?

  • malaise

 

  • fatigue

 

  • anorexia

 

  • nausea

 

  • weight loss

 

  • abdominal pain

19

What are the clinical signs that are present in all chronic liver disease?

 

i.e. compensated or decompensated

Hands:

  • leukonychia
  • palmar erythema
  • clubbing
  • Dupuytren's contracture

 

  • > / = 4 spider naevi on the chest / back

 

  • splenomegaly

 

  • tattoos may be present - this indicates possible site of hepatitis infection

20

What clinical signs are present in decompensated chronic liver disease?

  • asterixis 

 

  • jaundice

 

  • bruising

 

  • peripheral oedema

 

  • ascites 

21

What will blood tests show for someone with chronic liver disease?

  • FBC will show low platelets

 

  • LFTs will be deranged

 

  • coagulation studies will show prolonged PT or INR

22

What is the main consequence of chronic liver disease and what complications does this result in?

portal hypertension

 

  • oesophageal varices

 

  • caput medusae
    • distended / engorged superficial epigastric veins seen radiating from the umbilicus across the abdomen

 

  • haemorrhoids

 

  • splenomegaly & thrombocytopenia 

23

What functions of the liver are disrupted in chronic liver disease and what complications can this lead to?

Detoxification:

  • results in hepatic encephalopathy

 

Synthetic function:

  • results in bruising and ascites

 

Metabolism:

  • results in jaundice

24

What are other possible complications of chronic liver disease?

  • hepatocellular carcinoma

 

  • spontaneous bacterial peritonitis 
    • this is infection of the ascitic fluid 

25