Viral Hepatitis Flashcards Preview

Gastro > Viral Hepatitis > Flashcards

Flashcards in Viral Hepatitis Deck (51):
1

What is the main clinical maifestation of hepatitis viruses

Cause liver disease

2

Why has there been a decline of acute Hep A

Due to vaccination and better housing

3

Who is most commonly diagnosed with Hep B

Ethnic minorities who acquired Hep B mostly outside of the UK

4

What has caused the rise in Hep E in recent years

A mix of cases acquired outside the Uk and cases acquired within the UK

5

How is Hep A transmitted?

Faecal-oral
Poor hygiene / overcrowding

6

What are the common clinical presentations of Hep A

Usually asymptomatic

7

In what population is there a peak incidence of symptomatic disease

Older children / young adults

8

How is Hep A confirmed

Lab confirmation
Clotted blood for serology - yellow top bottle

9

How effective is the vaccine prophylaxis

Good - gives long term protection but needs 10 days to take effect

10

How is Hep A controlled?

Through good hygiene - infected food handlers are excluded from the workplace

11

Where is Hep E most common

In the tropics

12

What is more common in the UK Hep A or Hep E

Now Hep E

13

How is Hep E transmitted

Faecal-oral

14

What other animals can have Hep E

Pigs, deer, rabbits

15

How can some humans become infected with Hep E?

If they are immunocompromised

16

When is Hep D found

In association with Hep B

17

What is the effect of Hep D

It exacerbates Hep B

18

How is Hep B transmitted? (3 ways)

Sex
Mother to child
Blood (IV drug users)

19

What happens to the risk of chronic infection with increasing age at exposure

Decreases

20

What happens to the risk of acute hepatitis as age increases at exposure

Increases

21

Where is there a high prevalence of Hep B and why?

Canada, Alaska and Greenland
Due to their indigenous communities

22

How is Hep B confirmed

Lab - surface antigen (HBsAg) present in blood

23

What is also likely to be present in recently infected cases

Hep B IgM

24

How can we acquire immunity of Hep B

Vaccine or past infection

25

Describe the relationship between an indivual chronically infected with their infection

Dynamic - constantly changing - 1 treatment may not be applicable 1 day and would be the next

26

How can we control the spread of Hep B

Minimise exposure
safe blood,
safe sex
needle exchange
prevent needlestick injuries
Screening pregnant women

27

What would happen to the baby if the mother was Hep B positive during pregnancy

Given a vaccine at birth to prevent mother to child transmission

28

What are the two pre-exposure vaccination strategies

Vaccination of at risk people
Vaccination of all children / adolescents

29

How is Hep C transmitted

Similar to Hep B
Mother to child
Blood
Less often through sex

30

What are the precautions for Hep C

Minimise exposure
safe blood,
safe sex
needle exchange
prevent needlestick injuries
Screening pregnant women

31

How is hep C controlled

There is no vaccine
Minimise the exposure

32

What defines chronicc

six months of infection

33

What happens once there is a confirmed diagnosis for Hep C

Spontaneous cure is not seen

34

What is the time it takes for the infection to cause cirrhosis

Typically more than 20 years

35

How long does it typically take for Hepatitis C to cause heaptocellular carcinoma

More than 30 years

36

What is the management of acute viral hepatitis

No antivirals
Monitor for encephalopathy
Monitor for resolution of Hep B, C or E if immunocompromised
Notify public health
immunisation of contacts
test for other infections if at risk
Vaccinate against other infections i at risk

37

What is the management of chronic viral hepatitis

Antibrials
Vaccination
INfection control
Decrease alcohol consumption
Hepatocellular carcinoma awareness / screening

38

What are the 2 most commonly used therapies in HBV?

Adefovir
Entecavir

39

Who do we treat for viral hepatitis?

Chronic infection
Those at risk of complications
Those who are fit for treatment

40

When is it best to treat viral hepatitis?

Before complications arise
When there is evidence of inflammation - advanced fibrosis
When the patient is ready
When it is a clinical priority

41

What is interferon alfa

A human protein and part of the immune response to viral infection

42

How is interferon alfa made

Through genetic engineering

43

How is interferon alfa delivered

Given by injection

44

What are 3 side effects of interferon alfa

Flu like symptoms
Autoimmune disease
Psychosis

45

What are the 2 options for therapy of chronic hepatitis B

Peginterferon alone
Suppressive antiviral drug

46

What are the advantages of using Peginterferon

Sustained cure possible from a few months of therapy

47

What are the disadvantages of Peginterferon

Side effects
Injections
Only some benefit

48

What are the advantages of Suppressive antiviral drugs

Safer
Larger range available

49

What are the disadvantages of suppressive antiviral drugs

suppression not cure
resistance can develop

50

What are some of the aims/ benefits of chronic hep B therapy

Improved liver biochemistry
Improved histopathology
Reduced infectivity
Reduced progression to cirrhosis and primary hepatocellular carccinoma
Reduced mortality

51

What are some of the aims/ benefits of chronic Hep C therapy

Improved liver biochemistry
improved histopathology
reduced infectivity
reduced incidence of primary liver cancer
reduced mortality

Decks in Gastro Class (67):