Hepatitis A
Hepatitis A is not chronic and does not cause hepatocellular carcinoma.
What our notes say
- Hepatitis A is not chronic and does not cause hepatocellular carcinoma. (Junior Clerkship in Internal Medicine (MBIM4100) main exam, Paper One: 31 Januar)
- Hepatitis A (and E) are spread by the faecal-oral route. (Paediatrics end of second semester exam (MBPE 4300): 4 October 2022, cardiology,)
- Hepatitis A is a self-limiting faecal-oral infection that needs supportive treatment and does not become chronic. (Endocrinology and Gastroenterology Question Bank: 12 Clinical MCQs)
- Bilirubin is mixed, with an unconjugated majority (70 of 85 µmol/L), and the cause is likely acute viral hepatitis, so I would check hepatitis A, B and C serology. (Chemical Pathology Practice Examination)
- Recognised complications of acute hepatitis A include all EXCEPT: (Paediatrics end of 2nd semester exam (MBPE 4300): 5 October 2021, 50 MCQs)
- Topics tested: HIV and the gut, diarrhoea (infectious and non-infectious), alcoholic liver disease, hepatitis A, B and C, cirrhosis, liver tumours, cholera, shigella, gallstones and pancreatitis. (Internal Medicine CAT 1 (MBIM 6112), 2019/2020: gastroenterology and hepatology,)
Study material on Hepatitis A
- Paediatrics end of 2nd semester exam (MBPE 4300): 5 October 2021, 50 MCQs
- Paediatrics end of fourth year special supplementary exam: August 2019, Paper One, 87 of 100 MCQs
- Paediatrics end of second semester exam (MBPE 4300): 4 October 2022, cardiology, hepatology and gastroenterology, 47 of 50 MCQs
- Medical Virology CAT 2024/2025 — MKU MBMM 3333 Questions & Answers
- Pharmacology CRASH Course
- High-Yield Medical Mycology: Top CAT Exam Questions & Drugs
- Cytomegalovirus (CMV) Guide: Pathogenesis, Dx & Treatment
- Virology MCQs
Practice questions on Hepatitis A
NOT a symptom of acute hepatitis A?
- Nausea and vomiting
- Jaundice
- Fever and chills
- Headache
- Increased appetite
Answer: E. Anorexia (loss of appetite), not an increase, is typical.
How is hepatitis A transmitted?
- Respiratory droplets
- Fomites
- Sexually transmitted
- Fecal-oral route
- Bite of an infected vector
Answer: D. HAV is transmitted exclusively by the fecal-oral route — contaminated water, raw shellfish, unwashed produce, and poor hand hygiene. It is a non-enveloped virus, making it resistant to environmental conditions. Unlike HBV/HCV, it is NOT sexually transmitted or bloodborne as a primary route. ---
The diagnosis of hepatitis A virus infection is carried out from the method based on
- Aminotransferase levels
- Detection of faecal HAV by immunoelectron microscopy
- Detection of IgM anti-HAV by ELISA
- Both (a) and (b)
- Both a and b
Answer: C. The gold standard for acute HAV diagnosis is detection of IgM anti-HAV antibodies by ELISA — these appear at onset of symptoms and persist for 3-6 months. Elevated aminotransferases indicate liver injury but are nonspecific. Fecal HAV detection is possible but not the standard diagnostic method. ---
A 20-year-old male presents with anorexia, nausea, vomiting, and RUQ pain. He has a history of intravenous drug use and multiple sexual partners. Serological tests are negative for Hepatitis A, B, and C. What is the most likely cause of his symptoms?
- Acute Hepatitis E
- Drug-induced liver injury
- Autoimmune hepatitis
- Budd-Chiari syndrome
Answer: B. Given the history of intravenous drug use and multiple sexual partners, drug-induced liver injury (DILI) is a strong possibility. While Hepatitis E can cause acute hepatitis, it's typically acquired through contaminated water or food and less common in this demographic. Autoimmune hepatitis is a possibility but less likely without specific autoantibodies. Budd-Chiari syndrome involves hepatic vein obstruction. ---