hepatitis

Question 1

what are the pathological features of Hepatitis?

Answer 1

Liver cell necrosis and cell inflammation

Question 2

What is the prognosis for acute hepatitis?

Answer 2

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

Question 3

What are the clinical presentations of Hepatitis?

Answer 3

• Jaudice
• Enlarged and tender liver
• Laboratory evidence of hepatocellular damage
• Raised serum aminotransferase lvls

Question 4

What is the definition of chronic hepatitis?

Answer 4

> 6 months duration

Question 5

What are the viral causes of chronic hepatitis?

Answer 5

• Hepatitis B +/- D

* Hepatitis C

Question 6

Name 4 drugs that can cause Chronic Hepatitis?

Answer 6

• Methyldopa
• Nitrofurantoin
• Isoniazid
• Ketoconazole

Question 7

Name a hereditary cause of chronic hepatitis?

Answer 7

Wilson’s disease

Question 8

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

Answer 8

Alcohol

Question 9

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

Answer 9

Inflammatory bowel disease

Question 10

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

Answer 10

• Faecal/oral

* saliva

Question 11

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

Answer 11

• Blood/Blood product
• sexual
• Vertical
• Saliva

Question 12

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

Answer 12

•Blood/ Blood products

Question 13

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

Answer 13

• Blood/blood products

* Saliva

Question 14

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

Answer 14

• Faecal/oral

Question 15

What is the incubation period for Hep A?

Answer 15

2-6 weeks

Question 16

What is the incubation period for Hep B?

Answer 16

1-5 months

Question 17

What is the incubation period for Hep C?

Answer 17

2-6 months

Question 18

What is the incubation period for Hep D?

Answer 18

1-3 months

Question 19

What is the incubation period for Hep E?

Answer 19

3-8 weeks

Question 20

Which Hepatitis viruses cause Chronic liver disease?

Answer 20

• Hep B +/- D

* Hep C

Question 21

Which hepatitis viruses cause Liver cancer?

Answer 21

• Hep B
• Hep C
• Hep D (rare)

Question 22

When is Hep E really dangerous?

Answer 22

in pregnant women ( mortality 10 -20%)

Question 23

What are the symptoms for Hep A?

Answer 23

• Initially Fever, Malaise, Anorexia, Nausea, Arthralgia

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

Question 24

What are the symptoms for Hep B?

Answer 24

• Initially Fever, Malaise, Anorexia, Nausea, Arthralgia + Uticaria
• Followed by Jaundice (rare in children), Hepatosplenomegaly, adenopathy

Question 25

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

Answer 25

* Seafood (faecal/oral route) | * incubation period of 2-6 weeks

Question 26

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

Answer 26

* Recent foreign travel to an endemic area | * Incubation period of 1-5 months

Question 27

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

Answer 27

* Young intravenous drug user | * Chronic infection

Question 28

What are the tests for Hep B?

Answer 28

* 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

Question 29

What are the tests for Hep C?

Answer 29

* 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

Question 30

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

Answer 30

* Middle aged patient | * Chronic infection - Jaundice, malaise

Question 31

What is the treatment for Hep B?

Answer 31

The aim is to clear Hep B and avoid cirhoss, HCC. * Old method is to Treat with Pegelated interferon. * Lamivudine * entecavir * Adefovir * tenofovir

Question 32

What is interesting about chronic infections of Hep B?

Answer 32

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

Question 33

What is the treatment for Hep C?

Answer 33

* Genotype 1 → DAAs * sofosbuvir + ledipasvir +/- ribavirin * paretaprevir/r + ombitasvir + dasabuvir +/- ribavirin * Genotype 3 → Encouraging results with newer agents