Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

*Medicine: Gastrointestinal > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

Summary of all Hepatitis

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the key features of Hepatitis A?

A
  • Typically benign, self-limiting & doesn’t cause chronic disease
  • Transmission by faecal-oral spread or shellfish, often in institutions
  • Found world-wide, mainly affecting children + young adults
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the clinical features of Hepatitis A?

A
  • Incubation period → 2-4wks
  • Flu-like prodrome
  • Jaundice
  • Tender hepatosplenomegaly & RUQ pain
  • Complications rare, no inc risk of HCC

Tests → AST & ALT rise 22-40d after exposure, IgM rise indicates recent infection & IgG detectable for life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is immunisation available for Hep A, and if so, who should be immunised?

A

Effective vaccine available - booster given 6-12m after initial dose, should be given to:

  • People w/ chronic liver disease
  • IVDUs
  • People with HIV
  • Travelling to high endemic area
  • Occupational risk (lab, residential institution staff, sewage, primates)
  • Men who have sex with men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the key features of Hepatitis B?

A
  • Transmission via: blood, IVDU, sexual, vertical
  • Causes >1 million deaths / year
  • Endemic in Far East / Africa / Med
    *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the clinical features of Hep B?

A
  • Incubation period → 6-20wks
  • Fever
  • Jaundice
  • ↑ Liver transaminases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are complications of Hep B?

A
  • Chronic hepatitis → ‘ground glass’ hepatocytes
  • Fulminant liver failure
  • Hepatocellular carcinoma
  • Glomerulonephritis
  • Polyarteritis nodosa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Is immunisation available for Hep B, and if so, who to?

A
  • Children born in UK vaccinated @ 2, 3, 4 months
  • At risk groups:
    • healthcare workers
    • IVDU, sex workers, prisoners
    • close fam contact of individual w/ Hep B
    • if receiving blood transfusions regularly
    • chronic kidney disease pts requiring renal replacement therapy
    • chronic liver disease pts
  • 10-15% adults fail to respond to 3 doses of vaccine (40+, obese, smoker, drinker, immunosuppressed)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you interpet HBV serology?

A
  • Surface antigen (HBsAG) → present 1-6m after exposure (acute illness)
    • if present >6 months then this implies chronic disease (ie infective)
    • anti-HBs implies immunity (either exposure or immunisation)
    • prev immunisation = Anti-HBs positive, all others negative
  • HBeAg → present for 1.5-3m after acute illness + implies high infectivity
  • Anti-HBc → implies previous (or current) infection (c = caught)

Testing for anti-HBs is only recommended for those at risk of occupational exposure (i.e. Healthcare workers) and patients with chronic kidney disease. In these patients anti-HBs levels should be checked 1-4 months after primary immunisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you specifically interpret anti-HBs levels?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the management of Hep B?

A
  • Avoid alcohol
  • First-line → pegylated interferon-alpha (PEG)
  • Other antivirals → tenofovir, entecavir, telbivudine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the relationship between Hepatitis B and pregnancy?

A
  • All preg women offered screening
  • Babies born receive complete vaccination course + Hep B immunoglobulin
  • Little evidence to suggest C-section reduces vertical transmission
  • Hep B cannot be transmitted via breastfeeding (in contast to HIV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are key features of Hepatitis C?

A
  • Transmission → blood transfusion / ivdu / sex
  • Likely to become significant public health problem in UK
  • 200,000 chronically infected
  • Some vertical transmission (6%), worse with HIV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are clinical features of Hep C?

A
  • Incubation → 6-9wks
  • Only 30% develop features, 85% develop silent chronic infection
  • 25% get cirrhosis in 20yrs → <4% get HCC
  • Transient rise in serum aminotransferases
  • Jaundice
  • Fatigue
  • Arthralgia
    *
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the investigation for Hep C?

A
  • Diagnostic → HCV RNA
  • Pts eventually develop anti-HCV antibodies and those who spontaneously clear virus, will continue to have anti-HCV antibodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the outcome for Hepatitis C?

A
  • No vaccine
  • 15-45% will clear virus after an acute infection
  • Majority (55-85%) will develop chronic hepatitis C
17
Q

Chronic hepatitis C is the persistence of HCV RNA >6 months in blood. What are potential complications of chronic hepatitis C?

A
  • Rheumatological → arthralgia, arthritis
  • Sjorgen’s syndrome
  • Cirrhosis
  • HCC
  • Cryoglobulinaemia
  • Porphyria cutanea tarda
  • Membranoproliferative glomerulonephritis
18
Q

What is the management for chronic hepatitis C?

A
  • Depends on viral genotype
  • Aim → undetectable serum HCV RNA 6m after end of therapy
  • Treatment → protease inhibitors:
    • daclatasvir + sofosbuvir
    • OR sofosbuvir + simeprevir
    • +/- ribavarin
19
Q

What are key features and treatment of Hepatitis D?

A
  • Transmitted parenterally
  • Activated in presence of Hep B surface antigen
  • Pts may be infected with both Hep B + Hep D
  • Superinfection → Hep B surface antigen positive patient develops Hep D infection → high risk: fulminant hepatitis, chronic hep, cirrhosis
  • Diagnosis → reverse PCR of hep D RNA
  • Tx → interferon
20
Q

What are the key features of Hepatitis E?

A
  • Faecal-oral transmission
  • Incubation → 3-8wks
  • Common in central + SE Asia, N+W Africa, Mexico
  • Similar to Hep A but worse mortality (20%) during pregnancy
  • No chronic disease or increased risk of HCC
  • Vaccine in development
21
Q

Autoimmune hepatitis is condition of unknown aetiology which is most commonly seen in young females. Recognised associations include other autoimmune disorders, hypergammaglobulinaemia and HLA B8, DR3. Three types of autoimmune hepatitis have been characterised according to the types of circulating antibodies present.

What are the 3 types?

A
  1. TYPE 1 → Anti-nuclear antibodies (ANA) and/or anti-smooth muscle antibodies (SMA); seen in 80%; <40 yr females; affects adults + children
  2. TYPE 2 → Anti-liver/kidney microsomal type 1 antibodies (LKM1); Europe; children; → cirrhosis
  3. TYPE 3 → Soluble liver-kidney antigen; middle-age adults
22
Q

What are the clinical features and investigation findings of autoimmune hepatitis?

A
  • Chronic liver disease signs
  • Acute hep → fever, jaundice (only 25% present this way)
  • Amenorrhoea (common)
  • Signs of autoimmune disease → fever / malaise / urticarial rash / polyathritis / pleurisy

Investigation findings show: ANA/SMA/LKM1 antibodies, raised IgG levels, inflammation and bridging necrosis on liver biopsy, hypersplenism (↓ Hb, WCC + platelets)

23
Q

How do you manage autoimmune hepatitis?

A
  • Immunosuppressant therapy → Prednisolone 30mg/d PO 1 month
  • +/- Azathioprine to maintain remission
  • Remission achievable in 80% of pts within 3yrs
  • Liver transplant otherwise

Associations of AI hep → pernicious anaemia / UC / DM / PSC / autoimmune haemolysis

*Medicine: Gastrointestinal (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions