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2a Liver and GI > Hepatitis A-E > Flashcards

Hepatitis A-E Flashcards

(56 cards)

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1
Q

Viral hepatitis is…

A

inflammation of the liver resulting from viral replication within hepatocytes

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2
Q

Hepatitis A is a p______

A

picornavirus

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3
Q

Hepatitis A is spread…

A

faeco-orally

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4
Q

Where is hepatitis A most common?

A

Africa

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5
Q

True or false: Hep A can persist in water

A

True

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6
Q

What are ways to become infected with Hep A?

A

Travelling
Shellfish
Contaminated food or water
Poor sanitation
Close household contact
Overcrowding
Sexual contact
Contact through childcare groups
IV drug users
Infected food handlers

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7
Q

The first 2 weeks of infection is called p_____ phase and may not have characteristic symptoms

A

prodromal phase
May have malaise, N&V and fever

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8
Q

What are symptoms of Hep A after the first 2 week prodromal phase?

A

Jaundice
Dark urine
Pale stools
Hepatosplenomegaly

Rare complication = fulminant liver failure

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9
Q

Is Hep A a notifiable disease?

A

Yes to PHE

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10
Q

Is there an incubation period for Hep A?

A

Yes, 2 weeks.
Virus replicates in liver, excreted in bile.
Self limiting within 6 weeks.

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11
Q

Is there a vaccine for Hep A?

A

Yes, it is an inactivated virus, grown in human diploid cells

Traveller’s vaccine available

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12
Q

How often do you need the booster Hep A vaccine?

A

Once every 10 years

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13
Q

Is there a post-exposure prophylaxis for Hep A?

A

Yes, HAV immunoglobulins

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14
Q

Can Hep A lead to chronic liver disease?

A

No, it is self-limiting and acute

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15
Q

How would you diagnose Hepatitis A?

A

Bloods:
Increased ESR
Leukopenia

LFT:
Increased bilirubin when jaundiced (yellow from jaundice = icteric)

HAV serology:
HAV IgM when acutely infected

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16
Q

True or false: you have 100% immunity after infection of Hepatitis A

A

True

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17
Q

Is hepatitis E chronic?

A

Usually no, only acute condition.

However, in immunosuppressed can cause chronic disease and fulminant (sudden in onset) liver failure.

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18
Q

How is Hep E spread?

A

Faeco-orally
(water, dogs, pigs)

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19
Q

What type of virus is Hep E?

A

calcivirus

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20
Q

True or false: Hep E is less common than Hep A in the UK

A

False
Hep E is more common than Hep A in the UK

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21
Q

What is a major cause of Hep E?

A

Undercooked pork

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22
Q

What is the mortality rate for pregnant ladies with Hep E?

A

10-20%

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23
Q

How do you diagnose Hep E?

Study These Flashcards
A

HEV IgM in acute infection due to HEV RNA

24
Q

What is the treatment for Hep E?

Study These Flashcards
A

It is self-limiting
Supportive
There is a vaccine only in China

25
How is Hep D spread?
Bloodborne (IV drug users, tattoos, injection)
26
True or false: You have 100% immunity after Hep E infection
True
27
Can Hep D be chronic?
Yes
28
Hepatitis D requires what to replicate?
Hepatitis B
29
What percentage of those with Hep B infection are affected by Hep D infection?
5%
30
What immunoglobulins will someone infected with Hep D have?
IgM HDV and IgM HBV
31
What is treatment for Hep D?
Pegylated interferon alpha Over at least 48 weeks Has significant side effects so not for those with uncompensated liver cirrhosis. Low treatment success rates
32
What type of virus is Hep C?
Flavivirus
33
How does Hep C spread?
Blood borne - IV drug users Limited vertical/ sexual transmission
34
Can Hep C be chronic?
Yes
35
In the acute phase, what are symptoms of Hep C?
Mostly asymptomatic Some may have influenza like symptoms
36
What are later symptoms of Hep C
Chronic liver failure signs Hepatosplenomegaly
37
How do you diagnose Hep C?
Serology: HCV RNA = current acute infection HCV Ab = within 4-6 weeks of infection
38
How do you treat Hep C?
Direct Acting Antivirals (DAA): Sofosbuvir Oral ribavirin with other meds. Typically takes 8-12 weeks Some won't need treatment (1 in 4) Treatment always needed for chronic infection.
39
What are complications of Hep C?
HCC Liver cirrhosis
40
Is the Hep B virus DNA or RNA?
DNA
41
How does hepatitis B spread?
Through the blood or bodily fluids (semen, saliva) eg. needle stick, tattoos, sexual, vertical
42
True or false: hepatitis B is highly infectious
True, only a tiny amount is needed
43
Can hepatitis B cause chronic hepatitis?
Yes, if viral DNA is inserted into cell nucleus and continue to produce viral proteins. Cirrhosis and HCC
44
What are symptoms of Hep B?
V similar to Hep A 1-2 week prodrome Jaundice Dark urine Pale stools Hepatosplenomegaly Urticaria (hives) Arthralgia
45
What is the incubation period for Hep B?
1-6 months
46
How do you diagnose Hep B?
Serology
47
What are key viral markers of Hep B?
HBsAG (surface antigen) = active infection HBcAG (core antigens) = current or past infection HBsAB (surface antibodies) = current or past infection or vaccination. Shows immunity HBeAG (E antigen) = marker of viral replication implying high infectivity HBV DNA = direct count of viral load
48
We can measure Ig_ and Ig_ versions of the HBcAb
IgM and IgG
49
A high titre of IgM indicates
Active acute infection
50
A low titre of IgM indicates
Active chronic infection
51
IgG indicates...
A past infection
52
Is there a vaccination for Hep B?
Yes, 3 doses Inject HBsAg, then test HBsAB to check response.
53
Hepatitis B is characterised by l______ infiltrate leading to portal and lobular inflammation
lymphocytic
54
Can Hepatitis B be spread vertically?
Yes
55
How long do symptoms of Hep B last?
6-12 weeks
56
How do you manage Hep B?
Pegylated interferon alpha 2a Avoid alcohol Educate about reducing transmission Contact tracing USS for HCC Antiviral meds Liver transplant for fulminant hepatitis

2a Liver and GI (61 decks)

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