Viral Hepatitis Flashcards Preview

Year 2 - GI System > Viral Hepatitis > Flashcards

Flashcards in Viral Hepatitis Deck (46):
1

What's chronic hepatitis?

Hepatitis present for more than 6 months.
Causes variable changes in liver function

2

Name three causes of acute hepatitis.

Infection
Toxins/drugs/alcohol
Autoimmune
- wilson's
- heamochromatosis

3

Name some causes of infectious hepatitis.

EBV/cytomegalovirus
Toxoplasmosis
Leptospirosis
Q fever
Syphilis
Malaria
VHF - viral haemorrhagic fevers (e.g. Ebola)

4

What antibiotics are created in a hepatitis infection?

IgM is made first
IgG is made second

5

What class of virus is hepatitis A?

It's an ssRNA virus enterovirus (infects the enteric tract)

6

How is hepatitis A transmitted?

Feaco-oral
Contaminated food or water.
Human only reservoir

7

How long can hepatitis A survive inside and outside of the body?

Can survive for months in contaminated water.
There is no chronic carriage in humans.

8

Is hepatitis A likely to return after one infection?

No- there is a good immunity after infection

9

What is acute hepatitis and what does it cause?

Inflammation of the liver.
It raises ALT/AST and causes jaundice and clotting problems.

10

What are the clinical features of hepatitis A?

Fever
Abdominal Pain
Diarrhoea
Jaundice
Itch
Muscle Pain
However it is a self-limiting illness

11

What is the fatality rate of hepatitis A?

0.4% (1.75% in over 50s)

12

What is the treatment of hepatitis A?

No specific treatment
- maintain hydration
- avoid alcohol
- no vaccine to treat

13

How is hepatitis A diagnosed?

- Yields a positive IgM serology test
- RNA can be found in blood and/or stool
- IgG in the blood suggest they had it once, not currently

14

Who is normally vaccinated against hepatitis A?

Travellers
Gay men
IVDU
Chronic liver disease patients
- to contain any outbreak

15

What class of virus is hepatitis E?

A calicivirus (ssRNA)

16

How is hepatitis E transmitted?

Feaco-oral
Feacal contamination of water supply

17

What is the incubation period of hepatitis E?

40 days

18

What are the clinical features of hepatitis E?

Fever
Abdominal Pain
Diarrhoea
Jaundice
Itch
Muscle Pain
Some rare neurological effects

19

What is the fatality rate of hepatitis E?

1-3% (15-25% in pregnant women)

20

What is the treatment for hepatitis E?

- supportive
- pooled IgG doesn't prevent infection
- no vaccine to treat

21

Does the body chronically carry hepatitis E?

Yes - but usually only in immunosuppressed patients

22

Name the feaco-orally transmitted forms of hepatitis

A and E

23

Name the blood bourne hepatitis viruses.

B, C and D

24

What class of virus is hepatitis B?

It's a DNA virus (the only one out of A,B,C,D and E)

25

What are the vaccination guidelines for hepatitis B? (The most common hepatitis virus in the world?

Not commonly vaccinated against, unless in a high risk profession like medicine.

26

How is hepatitis B transmitted?

- vertical transmission
- contaminated needle
- child to child
- transplants/fluid
- most cases in the UK are from immigrants (picked up at antenatal screening)

27

Acute hepatitis has an incubation period of 2-6 months, and can cause what symptoms?

Fever
Fatigue
Jaundice
Myalgia
Joint Pain

28

If a child is infected with hepatitis B, what other symptoms might they have?

- asymptomatic
- can lead to chronic infection

29

How does clearing affect adults with hepatitis B?

At first they present symptomatically, but once they've cleared the virus, it attacks the liver

30

What's the fatality rate of hepatitis B?

0.5-1%

31

What are the problems associated with chronic hepatitis B?

- weight loss
- chronic liver damage
- abdominal pain/masses
- fever
- cachexia
- bloody ascites
- cirrhosis
- hepatocellular carcinoma
- death

32

What's the serology for hepatitis B?

Hep B antigen positive

33

What's the difference between a positive eAg serology and a negative?

eAg positive = high viral load, highly infectious, higher risk of CLD and hepatocellular carcinoma
eAg negative = opposite, but still has a small level of infection

34

What is the treatment for hepatitis B?

Acute has no treatment
Chronic has two types of therapy
- immunological
- anti-viral drugs

35

Describe the immunological and anti-viral treatment for hepatitis B.

Immunological
- pegylated interferon increases cellular immune response, but has lots of side effects
Anti-viral drugs
- tenofovir/entecavir suppress viral replication

36

How is vertical transmission of hepatitis B prevented?

- HBV vaccination for all newborns
- HBV immunoglobulin if eAg is positive
- Tenofovir is given to the mother during the last trimester

37

Hepatitis D needs which other hepatitis virus to replicate?

Hepatitis B
- so therefore has the same transmission
- vertical transmission is rare

38

How is hepatitis D acquired?

Co-infection with hepatitis B
Super infection of chronic HBV carries

39

How is hepatitis D treated?

Pegylated interferon alpha

40

How is hepatitis C transmitted?

Injections
Transfusion/transplant
Sexual
Vertical (rare)

41

How is hepatitis C prevented?

- no vaccine
- no reliable immunity after infection

42

How is hepatitis C diagnosed?

Because it's mostly asymptomatic, its normally picked up at screening.
HCV IgG positive means a chronic or cleared infection.
PCR positive means they currently have an infection

43

What's the treatment for hepatitis C?

There's a cure
Pegylated interferon alpha and ribavirin

44

In all hepatitis infections, what does sAg and sAb mean?

sAg = surface antigen, a marker of infection
sAb = surface antibody, a marker of immunity

45

In all hepatitis infections, what does cAb mean?

cAb = core antibody, means they have chronic or acute hepatitis

46

In all hepatitis infections, what does eAg and eAb mean?

eAg = suggests high infection
eAb = suggests low infection