Liver > Hepatitis > Flashcards

Hepatitis Flashcards

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1
Q

define hepatitis

A

inflammation of liver as a result of viral replication inside hepatocytes

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2
Q

on histology what would all types of hepatitis show?

A

interface necrosis

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3
Q

what must you do with all types of hepatitis?

A

report to public health

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4
Q

what is hepatitis A?

A

pircorna virus

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5
Q

in Hepatitis A: what is the virus type?

A
  • acute
  • single stranded RNA
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6
Q

in Hepatitis A: how is it spread?

A
  • Face- oral spread
  • contaminated water and food ( shellfish)
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7
Q

in Hepatitis A: what are the risk factors?

A
  • travel
  • eating shellfish
  • homelessness- overcrowding
  • living with people who have it
  • poor sanitisation
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8
Q

in Hepatitis A: what are the phases?

A
  1. incubation- 2 weeks no symptoms
  2. prodromal - pre-icteric
  3. Icteric
  4. recovery
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9
Q

in the prodromal phase ( 1-2 weeks)-what are the symptoms of Hepatitis A?

A
  • nausea and vomiting
  • fever
    -malaise
  • RUQ pain
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10
Q

in the icteric phase ( 3 months )-what are the symptoms of Hepatitis A?

A

-jaundice
-dark urine
- pale stool
-pruritus
-heapatosplenomegaly

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11
Q

how is hepatitis A diagnosed?

A
  1. bloods
  2. LFT
  3. Serology
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12
Q

what blood tests are done to diagnose HEP A?

A
  • high ESR
  • Leukopenia
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13
Q

what would LFT show in HEP A ?

A
  • high bilirubin
  • high ALT
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14
Q

what would serology show in HEP A ? (before/ after infection )

A

when under active infection - high HAV Igm antibodies
after infection - high anti HAV IgG antibodies

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15
Q

what is the treatment for HEP A?

A
  • supporting care
    -travellers vaccine
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16
Q

what are complications associated with HEP A?

A
  • fulminant liver failure- rare
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17
Q

what is HEP B?

A

Hepadna virus

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18
Q

in HEP B: what is the virus type?

A
  • double stranded DNA
  • Acute and chronic
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19
Q

in HEP B: how is it spread?

A
  • blood borne
  • bodily fluids
  • sharing needles
  • vertical/ horizontal transmission
  • dialysis
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20
Q

in HEP B: what are the symptoms in the prodromal phase ( 1-2 week)?

A
  • nausea and vomiting
  • fever
  • malaise
  • RUQ pain
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21
Q

in HEP B: what are the symptoms in the icteric phase ( few weeks- 6 months) ?

A
  • jaundice
  • dark urine
  • pale stools
    -prurritus
  • arthralgia
  • urticaria
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22
Q

in HEP B: how is it diagnosed?

A

serology

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23
Q

in HEP B: what does the serology look for?

A
  1. Hb S Ag- ( s- surface antigen)
  2. Anti Hb S Ag
  3. Hb E Ag
  4. Anti Hb E Ag
  5. HBV DNA
  6. Hb C Ag ( c- inner core antigen)
  7. anti Hb C Ag
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24
Q

in HEP B: in serology when does Hb S Ag appear?

A
  • in initial infection- 1-6 months
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25
in HEP B: in serology when does anti Hb S Ag appear and what does it indicate?
- indicates immunity or vaccination - appear 1-3 months after infection
26
in HEP B: in serology when does Hb E Ag appear?
infectivity and viral replication
27
in HEP B: in serology what does anti-Hb E Ag mean?
low activity and infectivity
28
in HEP B: in serology what does HBV DNA Show ?
viral load direct count
29
in HEP B: in serology what does Hb c Ag mean?
- not measured in practise - exposed to HEP B or some point
30
in HEP B: in serology when does anti Hb C Ag appear?
1. anti Hb C Igm- recent infection 2. anti Hb C IgG- resolved or chronic infection
31
in acute HEP B what would serology show?
HbsAg Igm Anti HBC Ag
32
in chronic HEP B what would serology show?
HbsAg IgG anti HbAg
33
in carrier HEP B what would serology show?
HbsAg IgG anti HbAg
34
in vaccine HEP B what would serology show?
anti HbsAg
35
In HEP B: what is the treatment?
-pegylated interferon alpha 2a -- anti viral properties - tenofovir -transplant
36
what is HEP C?
flavivirus
37
In HEP C: what is the virus type?
- single stranded RNA - acute and chronic
38
In HEP C: How is it spread?
- blood borne - bodily fluids - IVDU !!( Intravenous drug users )
39
In HEP C: what are the symptoms in acute ?
-asymptomatic or - malaise -fever -myalgia -arthalgia - nausea and vomiting - diarrhoea
40
In HEP C: what are the symptoms in chronic?
usual chronic liver signs hepatosplenomegaly
41
in HEP C: what is done for diagnosis?
serology
42
what would be present in serology in HEP C when you have no infection?
- anti HC ab -ve - Hc RNA -ve
43
what would be present in serology in HEP C when you have active infection?
- anti HC ab -ve - Hc RNA +ve
44
what would be present in serology in HEP C when you have resolved infection?
- anti Hc Ab +ve - HC RNA -ve
45
what would be present in serology in HEP C when you have acute infection- acute/chronic?
-anti Hc Ab +ve - Hc Rna +ve
46
what is the treatment for hepatitis C?
1. Direct Acting Antivirals ( DAA) 2. oral ribavirin + NSSA- I, + NSSB- I
47
IN HEP D: what is the virus type?
-single stranded RNA - acute and chronic
48
IN HEP D: what other hep does it depend on?
D- can only survive in patients with hep B - it attaches itself to HbSAg - HEP b + Hep D- HIGH cirrhosis + HCC ( Igm HDV + Im HBV)
49
IN HEP D what is the treatment, diagnosis, rf and symptoms the same as?
the same as hep b
50
what is the most common hep?
HEP E
51
IN HEP E: what is the virus type?
single stranded RNA acute
52
IN HEP E: how is it spread?
- faeco-oral spread -contaminated water - drugs -undercooked pork
53
IN HEP E: what are the symptoms?
usually asymptomatic and self limiting
54
IN HEP E: what are the complications?
- chronic disease in immunosupressed - fulminant liver disease
55
IN HEP E: how is it diagnosed?
serology
56
in non reactive HEP E- what is the serology?
anti HCV- negative HCV RNA- negative
57
in current infection HEP E- what is the serology?
anti HCV- positive HCV RNA- positive
58
in post infection HEP E - what is the serology?
anti HCV- positive HCV RNA- negative
59
what is the treatment for HEP E?
supportive self limiting
60
describe autoimune hepatitis
immune system attacks liver cells causing inflammation and damage
61
what are the risk factors for auto immune hepatitis?
- female - other autoimmune diseases - viral hepatitis - HLA DR3 or DR4
62
who is more likely to get type 1 autoimmune hepatitis?
adult females
63
who is more likely to get type 2 autoimmune hepatitis?
younger females
64
what auto antibodies are involved in type 1 autoimmune hepatitis?
anti nuclear antibodies (ANA) anti smooth muscle antibodies ( asma) anti soluble liver ag
65
what auto antibodies are involved in type 2 autoimmune hepatitis?
anti liver kidney microsomes 1 anti liver cytosol antigen type 1
66
what are the symptoms for autoimmune hepatitis?
- 25% asymptomatic -jaundice -fever -hepatosplenomegaly
67
how is autoimmune hepatitis diagnosed?
serology of antibodies
68
how is autoimmune hepatitis treated?
- corticosteroids -immunosuppressants -transplant
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