Viral hepatitis

Question 1

causes of viral hepatitis

Answer 1

Hep A-E
CMV
EBV

Question 2

transmission of hep a

Answer 2

faecal

usually contaminated food e.g. shellfish or water

Question 3

transmission of hep b

Answer 3

• paraenteral (through mucous membrane or skin: IVDU, tattoo, bites, cuts, sex)
• vertical

Question 4

transmission of hep C

Answer 4

paraenteral

Question 5

hep e transmission

Answer 5

faecal

Question 6

which is the most common acute hepatitis

Answer 6

hep a

Question 7

clinical features of viral hepatitis

Answer 7

N+V+D
malaise
abdo discomfort
fever
chosestatic jaundice

Question 8

what is fulminant disease

Answer 8

sudden and quick deterioration which can end with death. rare in all hep viruses but most common in hep B (5%)

Question 9

which hep viruses can cause chronic hepatitis/cirrhosis

Answer 9

hep a - NEVER

hep b and c can

Question 10

where is HBV particularly found

Answer 10

africa

middle east

Question 11

antibodies/antigens present in hepatitis B

Answer 11

HBsAg (hep b surface antigen)
HBcAg (hep b core antigen)
HBeAg (hep b e antigen)
HBsAb (hep b surface antibody)

Question 12

which positive test means the person is infected with HBV and can spread the virus

Answer 12

HBsAg (hep b surface antigen)

this can be either an acute or chonic infection

Question 13

what positive test shows that a person is protected against HBV

Answer 13

HBsAb (hep b surface antibody)

protected iether as result of vaccine or successfully recovering from past hep b infection

Question 14

what test result indicates a past or current hep b infection

Answer 14

HBcAb. Appears at the onset of symptoms in acute
HBV and persists for life. The presence of anti-HBc indicates previous or ongoing
infection with HBV

Question 15

when is HBeAg positive

Answer 15

6-12 weeks after acute illness

implies high infectivity

Question 16

which antbody is diagnositic of acute infection

Answer 16

IGM antibody to HBcAg

Question 17

rx hep b

Answer 17

no specific acute therapy. supportive (fluids antiemetics)

5% become chronic carriers

Question 18

what can be given for itch

Answer 18

chlorphenamine

Question 19

how is a chronic carrier of HBV defined?

Answer 19

serum HBsAg >6 months

Question 20

who are given treatment for HBV

Answer 20

chronic carriers with HBeAg in serum (highly infections and greatest risk of devleoping chronic hepatis and cirrhosis)

Question 21

what are patients with chronic hepatitis at increased risk of

Answer 21

hepatocellular carcinoma

Question 22

drugs for chronic HBV or HCV

Answer 22

peginterformin alfa-2a
entecavir
tenofovir

Question 23

is HCV acute or chonic?

Answer 23

either but often not detected till many years after infection through routine blood testing

Question 24

can patients clear HCV spontaeneously

Answer 24

25% do after the acute stage (so 75% get chonic infection)

Question 25

diagnosis of HCV

Answer 25

HCV antibodies

if positive, lood for HCV RNA