Brainscape's Knowledge GenomeTM

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


See full index

PHAM02 > hepatitis B > Flashcards

hepatitis B Flashcards

1
Q

type of virus

A

enveloped
hepatotrophic
DNA virus

blood borne virus

sexually transmitted

acute & chronic

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

what can acute hep B develop into

A

chronic infection
- liver cancer
- cirrhosis
- liver failure (decompensation)
- liver transplant

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

RF

A
  • perinatal exposure
  • multiple sexual partners
  • MSM
  • injection drug use
  • Asian, estern European, African ancestry
  • FHx HCC, HBC
  • household contact with HBV
  • male
  • Hx STDs
  • infected with HIV
  • infeted with HCV
  • health care worker
  • Hx improsonment
  • haemodialysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

prevention

A

immunisation

vaccine to high risk
- hyperendemic areas
- IVDU
- dialysis patient
- HIV patient
- pregnant
- MSM
- sexual & household contacts of HBV carriers who are -ve for HBV serology
-> vaccine at 0, 1, 6mth intervals

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

How infectious is hepatitis B?

A

x100 more times infectious than HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

incubation period of Hep B

A

40 - 160 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

symptoms

A

anorexia
abdominal pain
N&V
fever, chill
malaise
rash
dark urine
pale stools
jauncide (in acute)

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

differential diagnosis

A

chronic Hep C virus
CMV - cytomegalovirus
EBV - Ebstein barr virus
HSV - herpes simplex virus
autoimmune hepatitis

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

tests

A

LFTs
FBC
U&Es
coaguloathy - liver clotting cascade
serum antigens

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

treatment for hep B

A

nucleoside analogue +- liver transplant

1st line = Lamivudine 100mg OD oral

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

When is Hep b chronic?

A

> 6 months

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

How many develop chronic HB?

A

10 - 30%

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

aim of Tx for Hep B

A

slow progression of liver disease and reduce infections

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

secondary prevention

A

hep A vaccine

avoid heavy alcochol intake

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

complications of Hep B

A

cirrhosis

HCC (hepatocellular carcinoma)

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

What is cirrhosis?

A

immune reaction
inflammmation, cell death (necrosis), scarring (fibrosis) in the liver

more likely in older patients, alcohol abuse, infectd with HBeAg (-ve strain)

17
Q

HCC - hepatocellular carcinoma

A

usually 25-30yrs after acute infection

poor survival (5-6% survive >5yrs)

18
Q

When is Tx indicated?

A

in patients with high ALT, HBV DNa serum levels and inflammation of liver on biopsy

indicated if high risk of liver related morbidity or mortalityin ST (5-10yrs) or future (10-20yrs) and viral suppression likely during and after Tx

19
Q

Tx goal

A

HBV DNA levels that are not detectable

20
Q

1st line therapy (single agent)

A

entecavir

peginterferon alpha 2a

tenofovir

21
Q

How do the treatments work?

A

used to boost the immunesystem to raise a defence against the virus

22
Q

How often is the pegylated interferon given?

A

once a week injection

23
Q

Tx length for hepatitis B

A

up to 48 weeks Tx

24
Q

nucleoside/nucleotide analogues

A

lamivudine
telbivudine
entecavir
emtricitabine
adefovir & tenofovir

25
Q

How do nucleoside/nucleotide analogues work?

A

suppress/destroy HBV by preventing replication

26
Q

advantages of interferon therapy

A

– Short course therapy (48 weeks)
– Durable response
– Lack of resistance (just boosting immune system)

27
Q

disadvantages of interferon therapy

A

– Side effects (not tolerated by all pts)
– Parenteral administration
– Monitoring requirements (FBC etc)
– Moderate antiviral effect (main fxn is just boosting immune system)

28
Q

advantages of Nucleos(t)ide Analogues (NAs)

A

– Potent antiviral effect
– Good tolerance
– Oral Administration (tablet > injection)

29
Q

disadvantages of Nucleos(t)ide Analogues (NAs)

A

– Indefinite duration (LT)
– Potential for resistance
– Long term safety? (trials not long enough to ID safety info)

30
Q

What does Tx depens on?

A

patient factors:
- age
- severity of liver disease
- likely response
- potential for ADRs

  • co-infection or co-morbidity?
    – compensated cirrhosis?
    – decompensated cirrhosis?
    – HIV? (on Tx?)
    – Hep D co-infection?
    – chemotherapy? (immunosuppressant)
    – pregnant?
    – adult or child?

PHAM02 (32 decks)

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