Brainscape's Knowledge GenomeTM

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


See full index

GI Pathology > Viral Hepatitis > Flashcards

Viral Hepatitis Flashcards

1
Q

Define acute hepatitis.

A

Inflammation of the liver causing increased ALT/AST, jaundice and clotting derangement.

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

Define chronic hepatitis.

A

Hepatits present for more than 6 months, causing variable changes in liver function.

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

What are the causes of hepatitis?

A

Infection (hep A-E, CMV (herpes), toxo (parasitic), malaria, syphilis)

Toxins

Drugs

Alcohol

Autoimmune

Haemochromatosis

Wilson’s (increased copper).

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

What type of virus is hep A?

A

RNA virus.

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

How is hep A transmitted?

A

Faecal-oral
Person to person
Contaminated water/food (virus can survive for months in contaminated water).

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

What is the immunity of hepatitis A post infection?

A

Very good - no chronic carriage.

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

What are the clinical features of hep A?

A 
Fever
Abdominal discomfort
Diarrhoea
Jaundice
Itch
Muscle Pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the incubation period of hep A?

A

Around 30 days.

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

How can hep A be treated?

A

Generally self-limiting with little treatment.

Avoid alcohol and stay hydrated.

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

How is hep A diagnosed?

A

Antibody counts.

If acute hep A - IgM positive or RNA in blood/stool.

If previous infection/vaccination - IgG positive.

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

How can hep A be prevented?

A

Good hygiene
Methods to prevent food/water contamination
Vaccines

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

What are the two types of hep A vaccine, what are their features and who would they be offered to?

A

Havrix vaccine - inactivated virus given to everyone without contraindication.

Hepatits A immune globulin - collect blood from people who have had previous vaccination/infection and pools IgG.

Vaccines are given to people before travelling, homosexual men, chronic liver disease patients and IV drug users.
They are also given post-exposure to control outbreaks.

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

How many doses of the Havrix vaccine have to be given?

A

1st dose gives protection for 4 weeks.

2nd dose gives life protection.

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

What is the death rate for hep A?

A

Very low

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

What type of virus is hep E?

A

RNA

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

Is hep A or hep E more common in the UK?

A

Hep E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is hep E transmitted?

A

Faecal-oral
Pork products
Minimal person-to-person transmission.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How many genotypes of hep E are there?

A

4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the incubation period for hep E?

A

Around 40 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the clinical features of hep E?

A

Similar to hep A

(abdo pain, jaundice, itch, diarrhoea, muscle pain and fever) however also some rare reported neurological effects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the death rate for hep E?

A

1-3%, and higher in pregnant woman for some genotypes, including GT1.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How is hep E treated?

A

Supportive treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Is there a vaccine for hep E?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the immunity of hepatitis E post infection?

A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What group of patients are prone to hep E? How is this treated?

A

Very immunosuppressed patients.

Treat with ribavirin (anti-viral).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the neurological manifestations of hep E? What genotype are they thought to be associated with?

A

GT 3.

Gullian Barre syndrome (autoimmune muscle weakness)
Encephalitis (brain inflammation)
Ataxia (can’t coordinate muscles)
Myopathy (muscle weakness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Is a patient is positive for hep B or hep C, what should you also test for and why?

A

HIV, as they have the same transmission pattern.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What type of virus is hep B?

A

Hepadnavirus DNA virus.

29
Q

Is there a vaccine for hep B?

A

Yes - not currently part of UK vaccination programme.

30
Q

How is hep B transmitted?

A

Transfusion
- blood, blood products.

Mother to baby
- vertical transmission, usually at birth.

Contaminated needles and syringes.

Fluids
- semen, blood

Organs/tissue transplantation

Child to child

31
Q

What is the most common form of transmission in the UK?

A

95% are immigrants.

New sexual infections in th UK are rare.

32
Q

What are the most common forms of transmission in the tropics?

A

Vertically or during childhood between children.

Sexual

Iatrogenic (medical exam/treatment)

33
Q

What is the incubation period of hep B?

A

2-6 months.

34
Q

What are the clinical features of hep B?

A 
Fever
Fatigue
Jaundice
Myalgia
Joint pains
35
Q

What is the significance of age at the time of infection of hep B?

A

Determines severity of illness and risk of chronic hep B infection.

36
Q

Is infection at birth or in adulthood asymptomatic?

A

At birth - usually leads to chronic infection however.

37
Q

What are the complications of hep B?

A

Chronic liver disease
- cirrhosis, decompensation, hepatocellular carcinoma leading to death.

Signs of this:
Weight loss
Cachexia (wasting syndrome)
Mass in abdomen
Blood ascites (cancer?)
38
Q

What is sAg?

A

Surface antigen - marker of infection.

39
Q

What is sAb?

A

Surface antibody - marker of immunity.

40
Q

What is cAb?

A

Core antibody - shows if a person has seen the infection at some point (past or present).

41
Q

What is eAg?

A

e antigen - suggests high infectivity.

42
Q

What is eAb?

A

e antibody - suggest low infectivity.

43
Q

What does the presence of HBV DNA in the blood suggest?

A

Suggests current infection.

44
Q

How is hep B diagnosed?

A

Presence of sAg or DNA.

45
Q

What two groups can hep B carriers widely be divided into?

A

eAg+ve - early disease

  • high viral load with high risk of CLD (chronic liver disease) and HCC.
  • highly infectious.

eAg-ve - late disease

  • low viral load and lower risk of CLD and HHc.
  • less infectious
46
Q

How can acute and chronic hep B be treated?

A

Acute - no treatment

Chronic

  • Treat those with liver inflammation (LFT and biopsy)
  • No cure, just suppression of viral replication to make patients less infective.
47
Q

What drug therapies can be given to those with hep B?

A

Immunological

  • pegylated interferon alpha
  • many side effects
  • one year course

Antiviral Drugs

  • suppress viral replication
  • tenofoir and entecavir
48
Q

How can hep B be prevented?

A

Education
Screening of high risk groups
Immunisation

49
Q

What methods of immunisation are available for hep B?

A

Active (HBV sAg vaccine)
- high risk groups in UK

Passive (HBIG)

  • for babies born to some HBV+ mothers
  • post exposure in non-immune.
50
Q

What interventions occur in pregnancy to prevent HBV transmission?

A

HBV vaccination to all newborn.

HBV IG if eAg or high virus level.

Tenofovir during last trimester if high virus level.

51
Q

What type of virus is hep D?

A

Single stranded RNA virus.

52
Q

What other virus is needed to allow hep D replication?

A

Hep B

53
Q

How is hep D acquired?

A

Co-infection with hep B or super-infection of chronic HBV carriers (infection at a later date than hep B).

54
Q

What complications may arise with hep D infection?

A

Chronic liver disease.

55
Q

How can hep D be treated?

A

Peg IFN only.

56
Q

Give the 3 main transmission methods of hep B and D.

A

Blood, sex and needles.

57
Q

How is hep C transmitted?

A

Injecting drugs
Transfusion and transplant

Sexual/vertical transmission are rare.

58
Q

Is there a vaccination for hep C?

A

No

59
Q

Are there any treatments to prevent infection post-exposure?

A

No

60
Q

What is the immunity of hepatitis C post infection?

A

No reliable immunity.

61
Q

What are the most common genotypes of hep C in the UK?

A

1 and 3.

62
Q

What is the incubation period of hep C?

A

6-7 weeks

63
Q

How many people are symptomatic in hep C?

A

25%

64
Q

How many people go onto develop chronic infection in hep C?

A

70%

65
Q

What are the complications of chronic hep C?

A

Cirrhosis and HCC.

66
Q

How can hep C be diagnosed if the majority of patients are asymptomatic?

A

Usually by screening high risk groups such as drug users and immigrants (from high prevalence countries).

67
Q

What tests are done to diagnose hep C?

A

First - check for anti hep C IgG.
If positive then suggestive of a chronic or cleared infection.

Therefore a PCR or antigen test should be done.
If positive then current infection or viraemia.

68
Q

How can HVC be treated?

A

Direct-acting antivirals

  • regimen dependent on genotype and degree of fibrosis/cirrhosis
  • often giving alongside methadone to ensure compliance.

GI Pathology (4 decks)

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