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Flashcards in GI Deck (491)
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451

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

452

What are the two biggest issues in hepatitis E?

no vaccination available

very dangerous in pregnant women due to leading to fulminant hepatitis

453

What is the treatment and prognosis of hepatitis E?

good sanitation and hygiene

supportive treatment

10-20% mortality if pregnant

454

How is hepatitis C transmitted?

through childbirth, sex or blood

455

What is the virus in hepatitis C?

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

456

How long is the incubation period for hepatitis C?

6-9 weeks

457

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

458

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

increased specificity and decreased sensitivity in HCV

459

What is the treatment of acute hepatitis C?

educate and prevent

antiviral meds e.g. interferon

460

What precautions can be done to prevent hepatitis C?

screen blood products

lifestyle modifications

universal precautions of bodily fluids

461

Side effects of ribavirin antiviral meds?

haemolysis, pruritis, nasal congestion

462

Side effects of teloprevir antiviral meds?

rash and anaemia

463

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

464

How is hepatitis B transmitted?

childbirth, sex and blood

465

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

466

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

20%

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

467

what is a major complication of hepatitis B?

liver cancer

468

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

469

What is the incubation period for hepatitis B?

1-5months

470

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

471

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

chronic won't have IgM or IgG present

472

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

473

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

 

474

What scoring system is used in chronic hepatitis B?

Knodell scoring system

475

What virus is in hepatitis D?

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

476

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

477

What do investigations show in hepatitis D?

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

478

How is hepatitis D transmitted?

sex, bloods, IV drug users

479

What is the treatment of hepatitis D?

pergulated alpha 2a IFN

adifovir

480

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