VIRAL HEPATITIS Flashcards Preview

GASTRO-INTESTINAL MEDICINE AND HEPATOLOGY > VIRAL HEPATITIS > Flashcards

Flashcards in VIRAL HEPATITIS Deck (64)
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1

How many hepatitis viruses are known?

6
Hep A, B, C, D, E, and G (where is F??)

2

Other than the hepatitis viruses, what viruses can cause damage to the liver?

Cytomegalovirus
EBV
Yellow fever
Herpes viruses

3

What is the most common type of hepatitis virus worldwide?

Hepatitis A

4

What age group is most commonly affected by hepatitis A?

Young

5

What is the method of transmission of hepatitis A?

Faecal-oral route
Contaminated water or shellfish

6

What does the icteric phase refer to, with regard to hepatitis?

The time when the patient is jaundiced.

7

What are the symptoms of the prodromal phase (early stages) of hepatitis A infection?

Nausea
Vomiting
Diarrhoea
Headache
Mild fever
Malaise
Abdominal discomfort

8

How does hepatitis A affect smokers?

They have a sudden distaste for cigarettes.

9

How long after infection does the icteric (jaundiced) phase of hepatitis A occur?

10-14 days

10

How long does the icteric (jaundiced) phase in hepatitis A infection last for?

2-3 weeks

11

Other than jaundice, what are the symptoms of the icteric phase of hepatitis A infection?

Malaise and fatigue (which may persists for months)
Hepatomegaly
Splenomegaly in 10%

12

What would give you a definitive diagnosis of on going hepatitis A infection?

Rising titre of anti-hep A IgM
Demonstration of viral particles in stools by electron microscopy

13

What in the blood might reflect previous exposure to hepatitis A infection?

Anti-hep A IgG

14

What would LFTs show in someone with an on going hepatitis infection?

Moderately raised AST and ALT (500-1000 IU/L) which normalise rapidly

15

With reference to the icteric (jaundiced) phase of hepatitis A infection, when is the disease most infectious?

Just before the onset of jaundice

16

What are the complications of hepatitis A and how frequent are they?

They are actually quite rare

Myocarditis
Arthritis
Vasculitis
Fulminant hepatic failure (very rare)
Can precipitate autoimmune hepatitis

17

Does hepatitis A infection ever become chronic?

No and infact previous sufferers have lifelong immunity

18

How are patients with on going hepatitis A infection managed?

Treatment is supportive and hospital admission is not necessary in most cases.
Antiemetics for nausea
IV fluids in vulnerable patients (elderly)
Analgesia for headaches
Maintain calorie intake

Avoid alcohol

19

What is the incidence of symptomless hepatitis B infected individuals in the UK and USA?

0.1%

20

What is the method of transmission of hepatitis B?

Bodily fluid, mostly blood

Contaminated blood products
IV drug user
Sexual transmission
Vertical transmission (at birth) - most common worldwide
(Mosquitoes are possible)

21

Is hepatitis B transmitted by breast feeding?

No

22

What is the basic structure of the hepatitis B virus?

An inner nucleocapsid surrounded by an outer envelope of surface protein.

23

Is hepatitis B infection acute or chronic?

It can be either or it can be symptomless (carrier)

24

What is the incubation time of hepatitis B?

60-160 days

25

What are the symptoms of the prodromal phase (early stages) of acute hepatitis B infection?

Very non-specific
Arthralgia
Anorexia
Abdominal discomfort

26

Other than jaundice, what are the features of the icteric (jaundiced) phase of acute hepatitis B infection?

Fever
Hepatomegaly
Urticarial or maculopapular rash
Polyarthritis

27

What are the clinical features of chronic hepatitis B infection?

Most chronic carriers are asymptomatic

May present with features of chronic liver disease or cirrhosis: jaundice, ascites, portal hypertension, hepatic failure

28

What would LFTs of someone with acute hepatitis B infection show?

Very high AST and ALT (1000-5000 IU/L) for the first week but falling rapidly after this

29

What are the first markers to appear in serology of someone with hepatitis B infection and when do they appear?

Surface antigens (HBsAg) - 6 week to 3 months after infection

30

What is the serological marker which indicates increased virus replication and high infectivity of hepatitis B?

The e antigen (HBeAg)