hepatitis Flashcards Preview

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Flashcards in hepatitis Deck (33):
1

what are the pathological features of Hepatitis?

Liver cell necrosis and cell inflammation

2

What is the prognosis for acute hepatitis?

Normally self limiting with a return to normal structure and function.

3

What are the clinical presentations of Hepatitis?

• Jaudice

• Enlarged and tender liver

• Laboratory evidence of hepatocellular damage

• Raised serum aminotransferase lvls

4

What is the definition of chronic hepatitis?

> 6 months duration

5

What are the viral causes of chronic hepatitis?

• Hepatitis B +/- D

• Hepatitis C

6

Name 4 drugs that can cause Chronic Hepatitis?

• Methyldopa

• Nitrofurantoin

• Isoniazid

•Ketoconazole

7

Name a hereditary cause of chronic hepatitis?

Wilson's disease

8

What is the most common cause of chronic hepatitis in the UK.

Alcohol

9

what is a condition of the Gut associated with chronic hepatitis?

Inflammatory bowel disease

10

What is the transmission route of Hep A (HAV)?

• Faecal/oral

• saliva

11

What is the transmission route of Hep B (HBV)?

• Blood/Blood product

• sexual

• Vertical

• Saliva

12

What is the transmission route of Hep C (HCV)?

•Blood/ Blood products

13

What is the transmission route of Hep D (HDV)?

• Blood/blood products

• Saliva

14

What is the transmission route of Hep E (HEV)?

• Faecal/oral

15

What is the incubation period for Hep A?

2-6 weeks

16

What is the incubation period for Hep B?

1-5 months

17

What is the incubation period for Hep C?

2-6 months

18

What is the incubation period for Hep D?

1-3 months

19

What is the incubation period for Hep E?

3-8 weeks

20

Which Hepatitis viruses cause Chronic liver disease?

• Hep B +/- D

• Hep C

21

Which hepatitis viruses cause Liver cancer?

• Hep B

• Hep C

• Hep D (rare)

22

When is Hep E really dangerous?

in pregnant women ( mortality 10 -20%)

23

What are the symptoms for Hep A?

• Initially Fever, Malaise, Anorexia, Nausea, Arthralgia

• Followed by Jaundice (rare in children), Hepatosplenomegaly, adenopathy

24

What are the symptoms for Hep B?

• Initially Fever, Malaise, Anorexia, Nausea, Arthralgia + Uticaria

• Followed by Jaundice (rare in children), Hepatosplenomegaly, adenopathy

25

What is a good indicator that an individual might have Hep A?

• Seafood (faecal/oral route)

• incubation period of 2-6 weeks

26

What is a good indicator that an individual might have Hep B?

• Recent foreign travel to an endemic area

• Incubation period of 1-5 months

27

What is a good indicator that an individual might have Hep C?

• Young intravenous drug user

• Chronic infection

28

What are the tests for Hep B?

• The first and most important test is HBsAg ( Hep B surface antigen). this is the first serum marker seen in acute infection.

• HBeAg Appears during the first 1 1/2 - 3 months and can also be used as an acute marker of infection.

• HBcAg (Hep B core antibody) is initially IgM and if detected indicates Acute infection.

• HBcAg IgG replaces Igm. If this is detected without a HBsAg then it indicates the individual fought off a past infection

• Anti-bodies to Hep B surface antigen alone imply vaccination

29

What are the tests for Hep C?

• Anti-HCV Antibodies confirm exposure.

• HCV-PCR confirms on going infection/chronicity

• Liver biopsy if HCV-PCR +ve to assess Liver damage and need for treatment

30

What is a good indicator that an individual might have Hep E?

• Middle aged patient

• Chronic infection - Jaundice, malaise

31

What is the treatment for Hep B?

The aim is to clear Hep B and avoid cirhoss, HCC.

• Old method is to Treat with Pegelated interferon.

• Lamivudine

• entecavir

• Adefovir

• tenofovir

32

What is interesting about chronic infections of Hep B?

They will have been contracted as a baby (Vertical, blood products/saliva) and will have an incredibly high HBsAg

33

What is the treatment for Hep C?

•Genotype 1 → DAAs

•sofosbuvir + ledipasvir +/- ribavirin

•paretaprevir/r + ombitasvir + dasabuvir +/- ribavirin

•Genotype 3 → Encouraging results with newer agents