Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI lectures > Hepatitis > Flashcards

Hepatitis Flashcards

(57 cards)

Start Studying
1
Q

what do hepatitis cause?

A

inflammation of the liver primarily

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

how does Hepatitis A spread?

A

faecal-oral
poor hygiene/overcrowding
Some cases imported

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

what groups does hepatitis A cluster in?

A

gay men

people who inject drugs

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

what are the clinical effects of hepatitis A?

A

acute hepatitis, no chronic infection

peak incidence of symptomatic disease in older children/young adults

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

what is the lab confirmation of acute infection of Hep A?

A

clotted blood for serology (gold top container)

  • same sample for all causes of viral hepatitis
  • Hep A IgM (detectable at onset of illness)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how is Hep A controlled?

A 
hygiene
vaccine prophylaxis (only for at risk - travel, risk groups)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

where is Hep E most common?

A

tropics

has become more common then Hep A in the UK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is Hep E like clinically?

A

like Hep A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how does Hep E spread?

A

faecal-oral

often zoonosis in the UK (eg infected pigs, rabbits, deer)

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

which hepatitis is a real concern in pregnant women?

A

Hep E genotype in tropics causes severe disease in pregnant women

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

who is more likely to get a chronic Hep E infection?

A

immunocompromised

normal people get acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

hep D only occurs in people with Hep B, true or false?

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is Hep D?

A

parasite of a parasite
exacerbates Hep B
rare in scotland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how is Hep B spread?

A

sex
mother to child at delivery
blood to blood contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

who is at a higher risk of Hep B in the UK?

A

people born in areas of intermediate/high prevalence (outside NW Europe)
multiple sexual partners
people who inject drugs
children of infected mothers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hep B and hep C are spread similarly, true or false?

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

is there a Hep B vaccine?

A

yes

given to many children in first year of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how does lab confirm hep B?

A

hep B surface antigen in blood (HBsAg)
- present for >6 months = chronic
- HBeAg = highly infectious individuals
- Hep B virus DNA = high titre in highly infectious individuals, predicts risk of chronic liver disease and monitors therapy
Hep B IgM most likely present in recently infected cases
Anti HBs present in immunity/vaccinated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

does everyone with chronic infection have chronic liver disease?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the 4 phases of chronic infection?

A 
immune tolerance
immune clearance
immune control
immune escape
complex and dynamic relationship between virus and immune system so test values (ALT, HBV DNA etc) rise and fall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

how is Hep B controlled?

A

minimise exposure
- safe blood
- safe sex
- needle exchange
- prevent needlesticks
- screen pregnant women
2 pre-exposure vaccination strategies used:
- vaccinate all children born since August 2017
- vaccinate at risk older children and adults
Post-exposure prophylaxis (eg. after sex with infected)
- vaccine
- plus HBIG (hyperimmune hep B immunoglobulin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

can a vaccine prevent Hep B infection after sex with an infected person? How?

A

Yes

Long incubation period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how is Hep C spread?

Study These Flashcards
A

similar to Hep B

less easily by sex than Hep B

24
Q

hoes Hep C have a vaccine?

25
how common is chronic infection in Hep C?
75% of cases | not dependant on age at time of infection
26
how does age affect likelihood of getting symptoms in Hep A?
older at time of infection = more likely to get symptoms
27
what defines a chronic infection of hepatitis?
6 months infection
28
Is spontaneous cure common in Hep B?
not uncommon | even after many years of infection
29
is spontaneous cure common in Hep C?
once chronic infection established, never seen
30
what is the time frame from infection to cirrhosis?
usually >20 years
31
what is the time frame from infection to cancer?
>30 years
32
what is the most common hepatitis in Tayside?
C | some reduction in recent years
33
Hep E is very severe, true or false?
false | usually mild, rarely causes death
34
how does lab confirm hep C?
``` test if at risk or with signs of chronic liver disease test for antibody to Hep C virus - negative = not infected - positive = past or active infection if positive - test for Hep C virus RNA by PCR - positive = active infection - negative = no infection ```
35
how is Hep C controlled?
no vaccine | prevent needle sharing etc
36
how is acute viral hepatitis managed?
``` only if symptomatic no antivirals given monitor for encephalopathy monitor for resolution - of Hep B, C or E if immunocompromised notify public health immunise contacts test for other infections at risk of (eg. HIV, syphilis if having unprotected sex) vaccinate against other infections if at risk ```
37
how is chronic viral hepatitis managed?
``` antivirals - for Hep B and Hep C vaccination - other hep infections - if cirrhotic: influenza, pneumococcal infection control reduce alcohol hepatocellular carcinoma awareness/screening - important for patients with cirrhosis - serum alpha fetoprotein (AFP) and ultrasonography ```
38
what does ultrasound of liver look for?
nodules that could be cancer
39
what classifies a chronic infection?
HCV RNA present and genotype known HBsAg and Hep B DNA present > 6 months
40
what indicates risks of complications of treatment?
``` inflammation/fibrosis, cirrhosis sought, mainly in hep B high ALT (sign of inflammation) ```
41
when are people fit for treatment?
established cirrhosis more difficult to treat but are treated as priority liver cancer = contraindication HIV co-infection = urgent so stabilise HIV
42
when do you treat hepatitis?
``` before complications when evidence of inflammation (high ALT) -with advanced fibrosis, not yet cirrhosis and cirrhosis are priority when patient is ready clinical priority ```
43
what is interferon alpha?
used in Hep B part of innate immune response to viral infection given by injection as pegylated interferon (peginterferon) complex mode of action, including as immune adjuvant used less due to side effects
44
what are the side effects of peginterferon?
``` common - flu like symptoms less common - thyroid disease - autoimmune disease (SLE etc) - psychiatric disease - so if already have these don't use ```
45
what are the options for Hep B treatment?
``` usually option 1 1: - suppressive antiviral drug - safe and increasing range - only suppress don't cure - resistance can occur 2: - peginterferon alone - can cure but not always - side effects - good in HBsAg and HBeAg +ve people with good chance of cure ```
46
what are the aims of Hep B therapy?
``` virological - reduce HBV DNA - loose HBeAg - loose HBsAg (cure) improve liver biochem reduce infectivity reduce progression to cirrhosis/cancer etc reduce mortality ```
47
what are the aims of Hep C treatment?
loss of HCV RNA in blood sustained to 6 months after end therapy - known as sustained virological response (SVR) - relapse after SVR is rare but reinfection can happen
48
what is the choice of antiviral regime for HCV based on?
``` virus genotype patient's interferon response genes stage of disease past treatment experience likelihood of side effects cost effectiveness ```
49
what is the benchmark aim for HCV therapy?
>90% SVR
50
what do antivirals end in?
"...vir"
51
can HCV be cured with oral antivirals?
yes
52
when is a chronic Hep B infection more likely?
chronic infection more likely if first exposure in childhood
53
IgG +ve, RNA -ve?
Past infection
54
IgG +ve, RNA +ve?
current infection
55
list a side effect of ribavirin?
anaemia
56
what are the results of SVR?
``` improved liver biochem reduced infectivity reduced incidence of cancer reduced mortality improved hisopathology rare relapse ```
57
what is the standard for Hep C treatment?
oral, interferon free courses of 2 or 3 antivirals for up to 12 weeks with high SVR

GI lectures (75 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions