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Flashcards in GI Deck (491)
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What do investigations for hepatitis E show?

IgM antibody in active disease and IgG antibody in recovery disease

HEV RNA detected by PCR in stools/serum


What are the two biggest issues in hepatitis E?

no vaccination available

very dangerous in pregnant women due to leading to fulminant hepatitis


What is the treatment and prognosis of hepatitis E?

good sanitation and hygiene

supportive treatment

10-20% mortality if pregnant


How is hepatitis C transmitted?

through childbirth, sex or blood


What is the virus in hepatitis C?

single stranded RNA of the flavivirus family, and there is a rpid change in envelope proteins


How long is the incubation period for hepatitis C?

6-9 weeks


What do investigations show in hepatitis C?

HCV IgG antiobody after 8 weeks

HCV RNA detected seen with PCR - can show recovery or chronic progression

negative HAV and BBV markers

recombinant immunoblot assay


How does recombinant immunoblot assay compare with enzyme immunoassay in specificity and sensitivity in HCV?

increased specificity and decreased sensitivity in HCV


What is the treatment of acute hepatitis C?

educate and prevent

antiviral meds e.g. interferon


What precautions can be done to prevent hepatitis C?

screen blood products

lifestyle modifications

universal precautions of bodily fluids


Side effects of ribavirin antiviral meds?

haemolysis, pruritis, nasal congestion


Side effects of teloprevir antiviral meds?

rash and anaemia


What causes acute hepatitis C to lead to chronic?

Prolonged virus

Cytokines are profibrotic and lead to fibrosis

can be asymptomatic increased ALT and positibe HCV antibodies


How is hepatitis B transmitted?

childbirth, sex and blood


What is the virus causing hepatitis B and what is it made of?

a partially stranded, enveloped DNA virus with an e-antigen

outer surface protein of HBsAg with mutations that can lead to chronic

inner nucleocapsid

surface coat produced by infected hepatocyes


what percentage of acute hepatitis B develop to chronic and what does it largely depend on?


depends on what age you get the virus - the younger, the more likely


what is a major complication of hepatitis B?

liver cancer


What do investigation show in acute hepatitis B virus and what do these mean in its progression?

HBsAg = hepatitis B surface antigen

HBcAg = core antigen

e-antigen = marker of infected cells

IgM antibodies and IgG antibodies in window stage

HBV DNA in serum

serum sicklenesslike immunological syndrome - rashes, polyartitis, fever, arteritis


What is the incubation period for hepatitis B?



What is the treatment of acute hepatitis B?

treat symptoms, monitor markers

antiviral meds - entecavir and tenofovir

vaccine at 0, 1 and 6 years, 5 year booster


How do investigations of hepatitis B differ in acute and chronic?

chronic won't have IgM or IgG present


How do investigations in an active and inactive hepatitis B differ?

active - increased ATL, HBV DNA in serum

inactive - normal ATL, decreased HBV DNA in serum


What is the treatment of chronic hepatitis B?

  • seroconversion of HBeAG to antiHBe and reduce HBV DNA to
  • anitviral agents e.g. interferon, adefovir, entercavir, lamivuidine
  • daily tablet to stop replications of undetectable DNA
  • vaccination
  • post exposure prophylaxis
  • increases survival and reduces progression



What scoring system is used in chronic hepatitis B?

Knodell scoring system


What virus is in hepatitis D?

single stranded defective RNA that needs HBV, in the deltaviridae family


What is the difference between coinfection and superinfection in hepatitis D?

coinfection = B and D infect at the same time

superinfection = D infects after B which is more severe


What do investigations show in hepatitis D?

HDV IgM and IgG (but not a protective antibody is this casein active


How is hepatitis D transmitted?

sex, bloods, IV drug users


What is the treatment of hepatitis D?

pergulated alpha 2a IFN



What is the Rome III criteria for diagnositic IBS?

Recurrant abdominal pain at least 3 days a month with 2 or more of:

improvement of pain with defecation, change in stool frequency, change in form of stool