hepatitis

Question 1

what is hepatitis

Answer 1

inflammatory condition of the liver

Question 2

what are symptoms of hepatitis A

Answer 2

• fever
• malaise
• anorexia
• nausea
• arthralgia
• jaundice
• hepatosplenomegaly
• adenopathy

Question 3

who is at risk of hepatitis A

Answer 3

• people travelling
• people in overcrowded /poor hygiene areas
• gay men
• people who inject drugs

Question 4

how is hepatitis A spead

Answer 4

faecal-oral route

Question 5

how do you treat hepatitis A

Answer 5

• supportive

- avoid alcohol

Question 6

what confirms hepatitis A

Answer 6

HepA IgM in blood

• only ever acute never chronic - therefore there is no IgG in blood, only IgM

Question 7

What are symptoms of hepatitis B

Answer 7

• fever
• malaise
• anorexia
• nausea
• arthralgia (more than hepA)
• jaundice
• hepatosplenomegaly
• adenopathy

Question 8

who is at risk of hepatitis B

Answer 8

• intravenous drug users
• health workers
• haemophiliacs
• people who have a lot of sex

Question 9

how is hepatitis B spread

Answer 9

• blood (intravenous drug user)
• sexual
• direct contact
• mother to child

Question 10

what is the treatment for hepatitis B

Answer 10

Acute – supportive, avoid alcohol (no antivirals for acute)

Chronic – antivirals; adefovir, Entecavir, tenofovir, PEG interferon alpha

Question 11

what are the symptoms for hepatitis C

Answer 11

Early infection – asymptomatic/mild

¼ will get cirrhosis (4% of these get hepatocellular carcinoma)

Question 12

who is at risk of hepatitis C

Answer 12

• male
• older
• use of alcohol
• HIV

Question 13

how can you spread hepatitis C

Answer 13

• blood transfusion

- sexual

Question 14

how do you treat hepatitis C

Answer 14

• quit alcohol

- antivirals: simeprevir, ledipasivr, sofosbuvir

Question 15

what are symptoms of hepatitis E

Answer 15

clinically like hepA

Question 16

who can get hepatitis E

Answer 16

• immunocompromised humans can get chronic infection

Question 17

how is hepatitis E spread

Answer 17

• faecal-oral

- zoonosis

Question 18

what is treatment for hepatitis E

Answer 18

no specific treatment

Question 19

when IgM is present what type of infection is it

Answer 19

acute

Question 20

when IgG is present what type of infection is it

Answer 20

chronic

Question 21

what do you look at to help you diagnose hepatitis B

Answer 21

• HBsAG
• HBeAG
• anti-HBs
• anti-HBe
• anti-HBc
• HBV DNA PCR

Question 22

what is HBsAG

Answer 22

• surface antigen

- screen for evidence of infection

Question 23

what is HBeAG

Answer 23

• e antigen

- indicates high viral replication/infectivity

Question 24

what is anti-HBs

Answer 24

• surface antibody
• in infection usually seen with loss of HBsAG (indicating clearance of infection)
• in vaccinated people shows immunity

Question 25

what is anti-HBe

Answer 25

- e antibody | - indicates clearance of eAg/ reduced viral replication/ reduced infectivity

Question 26

what is anti-HBc

Answer 26

- core antibody | - only seen in previously infected patients ( not in vaccinated patients )

Question 27

what is HBV DNA PCR

Answer 27

- used to assess level of viraemia

Question 28

what causes acute viral hepatitis

Answer 28

- mainly caused by A,B,E

Question 29

what are symptoms of acute viral hepatitis

Answer 29

- abdominal pain - nausea - vomitting - jaundice - diarrhoea

Question 30

how do you diagnose acute viral hepatitis

Answer 30

- marked raised ALT and AST - bilirubin may be elevated - relativly normal Alk Phos/gamma-GT

Question 31

what is treatment for acute viral hepatitis

Answer 31

- supportive - monitor for fulfilment hepatic failure - antiviral rarely indicated notify public health

Question 32

what causes chronic viral hepatitis

Answer 32

C

Question 33

what are the symptoms of chronic viral hepatitis

Answer 33

- limited symptoms unless advanced disease