24 - Acute Hepatitis

Question 1

MCC acute liver failure now vs in the past (in US)

Answer 1

now - tylenol OD

past - Hep B

Question 2

2 findings necessary to call something acute liver failure instead of just hepatitis

Answer 2

encephalopathy and coagulopathy

Question 3

how is acute hepatic failure encephalopathy different from portal systemic encephalopathy?

Answer 3

acute is not treat w/ bowel cleansing

Question 4

4 grades of acute hepatic encephalopathy

Answer 4

1 - change in sleep pattern, mild change in menation/personality
2 - drowsiness, confusion, still coherent
3 - unconscious but arousable, incoherent
4 - with or w/o response to pain

Question 5

non-hep causes of acute liver failure

Answer 5

CMV, HSV (rare), toxo, leptospirosis, rickettsial dzs
chemical - drugs (tylenol!, INH), toxins (amanita from mushrooms)
autoimmune
metabolic - prenancy, Wilson’s dz
vascular - ischemia or congestion

Question 6

Budd Chiari syndrome

Answer 6

blockage of hepatic vein > congestive liver failure

Question 7

main sources of new cases of Hep B and C, respectively

Answer 7

B - sexual

C - IVDU

Question 8

which is worse - coinfection w/ Hep B and D, or superinfection w/ D over an existing case of B?

Answer 8

superinfection - more likely to progress to chronic infxn > cirrhosis > HCC