Flashcards in VIRAL HEPATITIS Deck (64)
How many hepatitis viruses are known?
Hep A, B, C, D, E, and G (where is F??)
Other than the hepatitis viruses, what viruses can cause damage to the liver?
What is the most common type of hepatitis virus worldwide?
What age group is most commonly affected by hepatitis A?
What is the method of transmission of hepatitis A?
Contaminated water or shellfish
What does the icteric phase refer to, with regard to hepatitis?
The time when the patient is jaundiced.
What are the symptoms of the prodromal phase (early stages) of hepatitis A infection?
How does hepatitis A affect smokers?
They have a sudden distaste for cigarettes.
How long after infection does the icteric (jaundiced) phase of hepatitis A occur?
How long does the icteric (jaundiced) phase in hepatitis A infection last for?
Other than jaundice, what are the symptoms of the icteric phase of hepatitis A infection?
Malaise and fatigue (which may persists for months)
Splenomegaly in 10%
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
What in the blood might reflect previous exposure to hepatitis A infection?
Anti-hep A IgG
What would LFTs show in someone with an on going hepatitis infection?
Moderately raised AST and ALT (500-1000 IU/L) which normalise rapidly
With reference to the icteric (jaundiced) phase of hepatitis A infection, when is the disease most infectious?
Just before the onset of jaundice
What are the complications of hepatitis A and how frequent are they?
They are actually quite rare
Fulminant hepatic failure (very rare)
Can precipitate autoimmune hepatitis
Does hepatitis A infection ever become chronic?
No and infact previous sufferers have lifelong immunity
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
What is the incidence of symptomless hepatitis B infected individuals in the UK and USA?
What is the method of transmission of hepatitis B?
Bodily fluid, mostly blood
Contaminated blood products
IV drug user
Vertical transmission (at birth) - most common worldwide
(Mosquitoes are possible)
Is hepatitis B transmitted by breast feeding?
What is the basic structure of the hepatitis B virus?
An inner nucleocapsid surrounded by an outer envelope of surface protein.
Is hepatitis B infection acute or chronic?
It can be either or it can be symptomless (carrier)
What is the incubation time of hepatitis B?
What are the symptoms of the prodromal phase (early stages) of acute hepatitis B infection?
Other than jaundice, what are the features of the icteric (jaundiced) phase of acute hepatitis B infection?
Urticarial or maculopapular rash
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
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
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