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37 Cards in this Set
- Front
- Back
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What is hepatitis? |
Inflammation of the liver |
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Name four infectious causes of hepatitis? |
Viral Fungal Bacterial Parasitic |
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Name four non-infectious causes of hepatitis? |
Alcohol Drugs Autoimmune diseases Metabolic diseases |
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What is the leading cause of liver cancer and the reason for many liver transplantations? |
Viral hepatitis |
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Hepatitis A is transmitted how?
How many cases per year? |
Faecal oral
1.4 million/year |
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How can hep A be transmitted? |
Close personal contact Contaminated food and water
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What kind of virus is hep A and in contaminated areas what percentage of 9 year olds have been infected? |
Picornavirus
The majority |
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Is hep A associated with chronic infection?
Overall mortality? |
No
0.2% most die of icteric jaundice of which 70% get |
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Describe the clinical phases of hep A |
Incubation 10-50 days Prodromal - 10 days flu and loss of appetite Icteric phase - 1-3 weeks: fever, jaundice, hepatomegaly Convalescence |
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Which comlication of hep A can be fatal in up to 60% of cases? |
Fulminant hepatitis |
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Rx of hep A? |
Supportive Treat symptoms such as vomiting and dehydration Notifiable Hep A vaccine (IVDU, clotting factor disorder, chronic liver disease and MSM) |
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Hep E virus transmission is via? |
Faecal oral route Associated with contaminated water supply |
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Hep E transmission is associated with eating what? |
Undercooked raw products and shellfish |
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Are person to person transmission rates high or low in hep E transmission? |
Low |
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Expalin the sequelae of hep E in immunocompetent patients? |
No chronic infection
Incubates for 40 days
Asymptomatic to acute liver failure |
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The sequelae are similar to which disease |
Hep a but more severe |
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Mortality? In what condition is mortality worse? |
0.5-4%
15-25% in late pregnancy |
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Diagnosis of HEV made on what? |
Serology IgG and IgM |
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Rx of acute hepatitis E? |
Supportive, check clotting, assess for encephalopathy |
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Hep B is transmitted how usually |
Blood borne:
Sexual Mother to child Needle sharing |
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Acute hep B presents how? |
Asymptomatic Non-specific Hepatitis |
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Chronic hep B leads to what? |
Chronic liver disease Cirrhosis HCC |
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Average incubation period for hep B? |
60-90 days |
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Outcome of infection in Hep B is linked to which two factors? |
Age at infection and immune response
i.e. virtually all children are asymptomatic 50% adults asymptomatic |
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Hep B accounts for what percentage of all HCC cases? |
53% |
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Define the serology associated with Hep B? |
HBsAg - Infected acute or chronic Anti-HBc IgM - recent infection Anti-HBc - Infected at some time HBeAg - Infected, acute or chronic Anti-HBe - Infected at some time Anti-HBs - Recovery from natural infection or vaccine response HBV DNA - Partly defines need for therapy |
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Rx options for Hep B? |
Immunomodulators or nucleoside analogues
Interferon alpha (60% response rate) |
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Name four nucleoside analogues and mechanism of action? |
Lamivudine, adefovir, entecavir, tenofovir
rapid reduction in HBV DNA
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Hep D is transmitted how? |
IVDU Sexual contact |
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How many people live with Hep C in the world today? |
170 million |
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Who is the key risk group for hep C? |
IVDU |
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Which five factors put you at higher risk of pathogenesis and sever liver fibrosis in hep C? |
Increased alcohol intake Age >40 HIV co-infection Male gender Chronic HBV co-infection |
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Assessment of chronic Hep c should include the following investigations.... |
LFT Symptoms Liver Biopsy Counsel about alcohol |
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Hep c sufferers should be immunised against? |
HAV and HBV |
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The goal of antiviral Hep C Rx is to... |
Clear HCV RNA Sustained virological response is associated with greatly reduced progression to cirrhosis |
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Combination antiviral thearpy in hep C involves? |
Interferon alpha and ribavirin
Pegylated interferon and ribavirin can clear virus in up to 80% of non-genotype sufferers |
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Name the new wave of drugs in the battle against Hep C? |
Telaprevir Boceprevir |
