Hepatitis Flashcards
(58 cards)
1
Q
Transmission HAV
A
Faecal to oral
2
Q
Transmission HBV
A
Parenteral
Sexual
Perinatal
3
Q
Transmission HCV
A
Parenteral
Sexual
Perinatal
4
Q
Transmission HDV
A
Parenteral
5
Q
Transmission HEV
A
Faecal-oral
6
Q
Main risk population for HAV
A
Travellers to endemic areas
Sewage workers
Contacts of cases
7
Q
Main risk populations for HBV
A
Immigrants from high prevalence areas PWID Multiple sexual partners Infants of HBsAg +ve mothers Health care workers
8
Q
Main risk population for HCV
A
PWID
Recipients of unscreened blood products
9
Q
Main risk populate HDV
A
PWID
10
Q
Main risk population for HEV
A
Travellers to endemic areas
Sporadic
exposure to undercooked pig products
11
Q
Chronic infection rate in HAV
A
None
12
Q
Chronic infection rate in HBV
A
5-10%
13
Q
Chronic infection rate in HCV
A
60-80%
14
Q
Chronic infection rate in HDV
A
People infected with HBV
15
Q
Chronic sequelae in HAV
A
None
16
Q
Chronic sequelae in HBV
A
Chronic hepatitis
Cirrhosis
Hepatoma
17
Q
Chronic sequelae in HCV
A
Chronic hepatitis
Cirrhosis
Hepatoma
18
Q
Chronic sequelae in DV
A
Chronic hepatitis
Cirrhoses
19
Q
Who is HEV VERY dangerous for?
A
Pregnant women
20
Q
What is the prevention of HAV
A
Inactivated vaccine
21
Q
What is the prevention of HBV
A
Recombinant vaccine
22
Q
For which of the hepatitis are there no vaccine
A
HCV
HDV (need to immunise against HBV to protect)
HEV
23
Q
Where is there a HDV vaccine present?
A
China
24
Q
For which is there a vaccine
A
A and B
25
For which is there no vaccine?
C
26
Rx for HBV
```
Pegylated interferon
Nucleoside analogues
Liver Tx (for advanced cirrhosis)
```
27
Nucleoside analogues used in HBV
```
Lamivudine
Adefovir
Dipivoxil
Telbivudine
Entecavir
```
28
What is the main prevention of HBV
Vaccination
29
Who is recommended for HBV vaccination
```
Health care workers
Travelling to endemic areas
Renal dialysis
PWID
Close contacts with those who have acute/chronic HBV
```
30
Which hepatitis viruses can be transmitted from the faecal-oral route?
A and E
31
How can HAV and HEV be prevented?
```
Good hand hygiene
Good sanitation
Clean water
Human normal immunoglobulin (HAV)
Active immunisation (HAV)
```
32
How is HAV Dx in the laboratory
Detection of hepatitis A lgM antibody
| in a serum sample.
33
Which hepatitis virus are spread by infected blood
B, C, D
34
How can HBV, HCV and HDV be prevented
Infection control precautions
Screening blood products
Safe sex
Vaccination for HBV
35
What is the purpose for testing serum for anti-abc IgM antibody?
Its presence indicates recent hepatitis
B infection. If a patient is tested late in the course of illness, HBsAg may have disappeared but the presence of IgM-anti HBc indicates recent infection.
36
Define chronic HB infection
HBsAg is persent in serum for at least 6 months
37
What percentage of adults will become chronically infected with HBV after acute infection
5-10%
38
What percentage of children with acute HBV will become chronically infected
40%
39
What percentage of infants with acute HBV infection will become chronically infected
90%
40
Who should be vaccinated against HBV?
Healthcare workers
Close contacts of those with acute or chronic HBV infection
Selected police and emergency services
PWID
Individuals who change sexual partners frequently
Inmates of custodial institutions
Some patients with chronic liver disease
41
What is the clinical important of infection with HCV
60-80% will show evidence of chronic liver disease and are at risk of progression to cirrhosis
42
What laboratory assessment would you make of someone with antibodies to HCV
Serum ALT
| HCV RNA
43
What factors is essential for the transmission of HDV
Presence of HBsAg
44
What is the commonest mode of hepatitis D transmission
Injection drug use
45
Interpret:
History of recent jaundice in a 26 year old homosexual.
Hepatitis B surface antigen negative. Hepatitis B core antibody negative. Hepatitis A IgM positive.
Evidence for recent hepatitis A infection
| No evidence for hepatitis B infection
46
Interpret:
Antenatal screen in a 30 year old woman.
Hepatitis B surface antigen positive. Hepatitis B e antigen positive.
Hepatitis B e antibody negative. Hepatitis B core IgM antibody negative. Hepatitis B core total antibody positive.
Results consistent with chronic hepatitis B infection. The presence of surface antigen indicates infectivity. The presence of e antigen indicates high infectivity.
The absence of IgM anti-core indicates the infection is not recent.
Arrangements should be made in advance so that the baby is protected against HBV
47
```
Interpret:
History of past injecting drug use.
Hepatitis A antibody negative
Hepatitis B surface antigen negative. Hepatitis B core total antibody positive. Hepatitis B surface antibody positive. Hepatitis C antibody positive.
Hepatitis C RNA positive.
```
No recent or past infection with HAV
Results consistent with past HBV with seroconversion to antibodies
Ongoing infection with HCV
48
Interpret:
Recent onset jaundice in a 65 year old diabetic man who has not been abroad recently.
Hepatitis A IgM negative.
Hepatitis B surface antigen negative. Hepatitis B core total antibody negative. Hepatitis C antibody negative.
Hepatitis E IgG antibody positive. Hepatitis E IgM antibody positive. Hepatitis E RNA positive
Recent HEV
No evidence for recent HAV detected
No evidence for infection with HBV
49
Interpret:
Going to live in Africa. Is immunisation needed?
Hepatitis A total antibody positive. Hepatitis B core total antibody negative.
Evidence for past infection with hepatitis A immunisation not indicated
No evidence for previous HBV infection
Immunisation is indicated
50
Interpret:
HBsAg negative
Anti-HBc negative
Anti-hBs negative
No infection
But not immunised
Therefore susceptible
51
Interpret:
HBsAg negative
anti-HBC positive
anti-HBs positive
Resolved past infection
52
Interpret:
HBsAg negative
Anti-HBC negative
Anti-HBs positive
Immunity due to vaccination
53
Interpret:
HBsAg positive
Anti-HBC positive
Anti-HBs negative
Active HBV infection
54
What does the present of Anti-HBC IgM indicated
May represent acute infection
55
What does the presence of Anti-HBC IgG indicate
May represent more chronic HBV infection
56
Interpret Vaccination result >100 Anti-HBs
Good response
| Booster in 5 yrs
57
Interpret Vaccination result 10-100
Response but poor response
| Booster now and in 5yrs
58
Interpret Vaccination result <10
No response to vaccine
Repeat course of vaccine
Recheck antibody dose after
