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Core conditions Olivia MD > Hepatitis > Flashcards

Flashcards in Hepatitis Deck (24):
1

Out of all the Hepatitis viruses, which one is the DNA virus?

hep B

2

what are the serological test results for acute hep B?

HbsAg +, Anti HbsAg neg, Anti HbcAg IgM

3

What are the serological test results for chronic hep B?

HbsAg +, Anti HbsAg neg, Anti HbcAg IgG

4

what are the serological test results for vaccinated hep b patients?

HbsAg -, Anti HbsAg +, Anti HbcAg

5

when do we start antiviral treatment for chronic hep b? think which phase?

Phase 2 (immune clearance) and Phase 4 (immune escape)

6

what is the best LFT marker for hepatitis?

ALT

7

during which phase do we seroconvert from HbeAg + to HbeAg-?

from phase 2 to phase 3

8

with what imaging modality do we assess fibrosis of the liver?

Fibroscan ultrasound and ARFI- acoustic radiation force impulse

9

when would we prefer to take a Liver biopsy with hep B?

if ALT is elevated and Hep B DNA is greater than 2000 IU.

10

what medications do we prescribe for hep B typically?

Entecavir, tenofovir or peg interferon and lamivudine

11

what hepatitis virus is associated with hepatitis B? e.g. coinfection or superinfection

hepatitis D

12

how many genotypes are there for hep C?

7 genotypes, with their own subtypes

13

what are some SE of interferon therapy?

Interferon therapy can cause neutropenia, depression, aches and pains, alopecia

14

What is the pattern of inflammation for acute viral hepatitis?

lobular inflammation

15

what is the pattern of inflammation for chronic viral hepatitis

portal inflammation

16

which viral hepatitis carries higher risk of HCC?

hep B

17

what are the autoantibodies associated with autoimmune hepatitis?

Type 1: SMA, ANA (smooth muscle, Anti nuclear)
Type 2: LKMI (liver kidney microsomal Abs)

18

how do we treat autoimmune hepatitis?

prednisolone or budesonide

19

what do we mean by overlapping syndromes of autoimmune hepatitis?

autoimmune hepatitis +/- PBC or PSC

20

what is the relationship between hepatitis and kidney injury?

hepatitis can be associated with cyroglobulinemia which can deposit IgM in the glomerulus and cause renal injury

21

what antibiotic can cause hepatitis? (transient hepatitis)

flucloxacillin

22

how long is the incubation period for hep A?

30 days- 2-3 weeks

23

How does Hep B replicate?

1. Hep B virus infects hepatocytes in the liver and
following entry into the core of the virus, the
double stranded DNA moves into the nucleus, and
in the presence of nucleotides, completes a repair
of the ‘gap/incomplete’ section of its ds DNA
genome. ! becomes a covalently closed circular
DNA episome (CCCDE). This resembles a mini
chromosome in the nucleus of the host cell.

2. Pre-genome RNA is produced, and goes more
than one circle around the covalently closed
circular DNA episome. Remember that the pregenomic
RNA produces the core protein as well
as polymerase.

3. Forms a nucleocapsid! then undergoes reverse transcription to DNA! viral DNA is produced. It can either
go back to the nucleus as CCCDE or go to the ER ! get surface antigens! becomes true virus and buds off.

24

Describe the 4 stages of hep B

1. Immune tolerance- High Hep B viral load, HbeAg +ve, normal ALT/AST

2. Immune clearance- falling hep B viral load, HbeAg +ve, rising ALT/AST (treatment indicated)

3. Immune control- lower hep B viral load, HbeAg-ve, normal ALT/AST

4. Immune escape- rising hep B viral load, HbeAg-ve, rising ALT/AST