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JL Gastrointestinal > Viral hepatitis > Flashcards

Flashcards in Viral hepatitis Deck (44):
1

What id the chief or sole clinical manifestation of hepatitis viruses?

Liver disease

2

How is hepatitis A transmitted?

Feacal-oral spread

3

What hepatitis is related to poor hygiene and overcrowding?

Heptatitis A

4

In what patients is there peak incidence of symptomatic hepatitis A?

Older children and young adults

5

What are the two investigations for labaratory confirmation of hepatitis A?

1. Clotted blood for serology
2. Hepatitis A IgM

6

What are the two methods for control of hepatitis A?

Hygiene
Vaccine prophylaxis

7

What virus is more common in tropics, clinically like hepatitis A and has become more common than hep A in UK?

Hepatitis E

8

How is hepatitis E transmitted?

Faecal-oral

9

Where is the evidence of chronic hepatitis E infection?

In pigs

10

Which virus is only found with hepatitis B?

Hepatitis D

11

What are three methods of transmission of hepatitis B?

1. Sex
2. Mother to child
3. Blood

12

What virus is likely with unscreened transfusions, needlesticks and tattoos?

Hepatitis B

13

What does the HBsAg indicate?

Patient is infected and infectious

14

What does anti-HBe indicate?

Low infectivity

15

What is done in the laboratory to confirm hepatitis B?

HBsAg

16

How long does HBsAg have to be present for it to be chronic infection?

6 months

17

What is the Hep B virus DNA like in highly infectious individuals?

High titre

18

What hepatitis B cases have Hep B IgM present?

Acute

19

What are Anti-HBs present in?

Immunity

20

What are two post-exposure prohpylaxis methods for hepatitis B?

1. Vaccine
2. plus HBIG (hyperimmune Hep B immunoglobulin)

21

What hepatitis virus has similar transmission to hepatitis B (e.g. sex etc)?

Hepatitis C

22

What should you test for if a patient is at risk of hepatitis C or with signs of chronic liver disease?

Test for antibody to hepatitis C virus

23

When testing for hepatitis C, if the antibody test comes back positive (past or active infection), what is the next step?

Test for hepatitis C virus RNA by PCR

24

If the test for hepatitis C virus RNA by PCR is negatie what does it mean, and if it is positive what does it mean?

Negative - past infection
Positive - active infection

25

Is there a vaccine for hepatitis C?

No

26

Once chronic hepatitis C infection is established, what is not seen?

Spontaneous cure

27

What two factors should you monitor when managing acute viral hepatitis?

1. Encephalopathy
2. Resolution

28

Who should be notified when there is an acute viral hepatitis case?

Public health

29

If cirrhotic, what vaccinations should be given to manage chronic viral hepatitis?

Influenza and pneumococcal

30

For patients with chronic viral hepatitis, how should hepatocellcular carcinomas be screened for?

1. Serum alpha fetoprotein (AFP) and ultrasonography

31

What are the two main drugs used for chronic hepatitis B therapy?

Adefovir
Entecavir

32

What are tenofovir, lamivudine, telbivudine and interferon used in?

Chronic hepatitis B infection

33

In chronic hepatitis C infection, what is given with peg interferon alpha?

Ribavirin

34

For treating chronic hepatitis infections, what to factors must be present?

1. HCV RNA present and genotype known
2. HBsAg and Hep B DNA present

35

What does increased ALT suggest?

Biochemical evidence of inflammation

36

What condition is a contraindication for hepatitis treatment?

Liver cancer

37

What are four side effects of interferon alpha?

Flu like symptoms, autoimmune disease, psychosis, thyroid disease

38

What drug for hepatitis treatment is a human protein?

Interferon alpha

39

Give one side effect of ribavirin?

Anaemia

40

Give two side effects of telaprevir and boceprevir?

Rash and aneamia

41

What is the difference in end result with chronic hepatitis B infection using peginterferon or antiviral drugs?

Peginterferon - sustained cure possible
Antiviral - suppression

42

What are two conditions which can follow on from hepatitis B chronic infection?

Cirrhosis and primary hepatocellular carcinoma

43

What is the aim of chronic hepatitis C therapy?

Response defined by loss of HCV RNA in blood sustained to 6 months after end of therapy

44

What two older antivrals for hepatitis C can be used against all genotypes?

Peginterferon alfa anf ribavirin