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Clinical - Winter > 3 - Hepatitis > Flashcards

3 - Hepatitis Flashcards

1
Q

Which hepatitis viruses are transmitted through fecal-oral contamination?

A

A and E

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2
Q

Which hepatitis viruses are transmitted parenterally?

A

B, C, and delta

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3
Q

What is important to note about delta hepatitis?

A

Must have a co-infection w/ hepatitis B

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4
Q

How can the hepatitis A virus be killed?

A

Only with extreme high temperatures, not extreme cold temps

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5
Q

Is the hepatitis A or hepatitis B virus able to survive in the environment for longer?

A

Hepatitis A (can survive for months)

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6
Q

What are the risk factors for hepatitis A?

A
  • International travelers
  • Household or sexual contact w/ HAV infected person
  • Users of illegal drugs
  • Px w/ chronic liver disease
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7
Q

What is the incubation period for hepatitis A?

A

Approx. 28 days (range 15-50 days)

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8
Q

When do px infected w/ hep A begin to shed the virus?

A

1-2 weeks after exposure

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9
Q

What are the stages of acute hepatitis A?

A
  • Prodromal period
  • Acute illness w/ abrupt onset
  • Icteric hepatitis
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10
Q

What are sx of the prodromal period of hepatitis A?

A

Flu-like sx (some may be mild) like anorexia, nausea, fatigue, malaise

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11
Q

What are sx of hepatitis A w/ acute illness w/ abrupt onset?

A
  • Anorexia
  • Nausea, vomiting
  • Malaise
  • Fever
  • Headache
  • Right upper quadrant abdominal pain
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12
Q

What are sx of icteric hepatitis?

A
  • Dark urine
  • Light-coloured stools
  • Worsening of sx
  • Pruritus
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13
Q

What happens to liver enzymes during hepatitis A?

A

Increase w/in the first few weeks of infection, peak is about 4th week, and normalize by 8th week

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14
Q

How do symptoms of hepatitis A differ in age groups?

A
  • < 6 y/o are likely asymptomatic
  • Older children and adults have sx lasting < 2 months
  • In adults, peak viral shedding precedes GI sx
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15
Q

Can HAV result in a chronic infection?

A

No

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16
Q

What some possible complications associated w/ hepatitis A?

A
  • Relapsing hepatitis
  • Cholestatic hepatitis
  • Fulminant hepatitis
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17
Q

What is the treatment for hepatitis A?

A
  • Majority of px have clinical resolution by 2 months, nearly all by 6 months
  • Non-specific tx, general supportive care
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18
Q

How can hepatitis A be prevented?

A
  • Vaccination

- Human immune globulin

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19
Q

What is the dosing for the hepatitis A vaccine?

A

Intramuscular injection w/ one dose (primary immunization) and then booster 6-36 months later

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20
Q

Who should receive a hepatitis A vaccine?

A

Individuals >/ 6 m/o at risk of infection or severe hepatitis A, or those wanting to decrease risk of acquiring hep A

21
Q

What are adverse events from the hepatitis A vaccine?

A
  • Generally well tolerated

- Mild and transient soreness or redness at injection site

22
Q

Can the hep A and hep B vaccines be given to pregnant women?

A

Yes b/c is an inactivated vaccine

23
Q

Patients who have ____ can not receive the hep A or hep B vaccine

A

Moderate to severe acute illness

24
Q

How should receive human immune globulin?

A
  • Infants < 6 m/o
  • Px w/ contraindication to hep A vaccine
  • If hep A vaccine unavailable
  • Should be given in addition to hep A vaccine in immunocompromised or px w/ chronic liver disease
25
Q

When should human immune globulin be given when used for post-exposure prophylaxis?

A

As soon as possible after exposure (no more than 14 days after exposure)

26
Q

What are some non-pharms for hep A prevention?

A
  • Eat and drink safe food and water (fully cooked food, boiled water)
  • Frequent handwashing
27
Q

How is hep B transmitted?

A

Percutaneous or mucosal contact w/ blood and biological fluids containing the virus

28
Q

What are some risk factors for contracting hep B?

A
  • Infants exposed during child birth
  • Sexual contact
  • Injection drug use
  • Household contact of HBV-positive px
  • Procedures w/ percutaneous exposure if tools are not sterilized
29
Q

Can HBV be transmitted through breastfeeding?

A

Not through the milk, only if nipples are cracked and blood is present

30
Q

What is the incubation time for HBV?

A

Average 60-90 days

31
Q

What are sx of hep B?

A
  • Majority are asymptomatic

- Sx include anorexia, abdominal pain, N/V

32
Q

How long can acute illness of hep B last?

A

Up to 3 months, but most have spontaneous clearing after 4-8 weeks

33
Q

Which group of px has the highest risk of becoming a chronic HBV carrier?

A

Infants

34
Q

What do chronic HBV carriers have an increased risk of?

A

Developing cirrhosis and hepatocellular carcinoma

35
Q

What is the tx for acute hepatitis B?

A

No specific tx; only treated if signs of liver damage (ex: jaundice)

36
Q

How can hep B be prevented?

A

Vaccine

37
Q

What is the dosing schedule for monovalent hepatitis B vaccine?

A

Intramuscular injection beginning w/ one dose at month 0, then repeated at month 1 and month 6

38
Q

What are indications of the hepatitis B vaccine?

A
  • People working in healthcare setting, correctional facilities
  • Sexual or household contacts of HBV carrier
39
Q

What are adverse events associated w/ hep B vaccine?

A
  • Well tolerated

- Mild and transient irritability, headache, fatigue, redness and injection site

40
Q

Who should receive the hep B vaccine as post-exposure prophylaxis?

A
  • Infant of mother w/ acute or chronic hepatitis
  • Percutaneous or mucosal exposure to blood or body fluids that may contain HBV
  • Sexual or household contacts of individual w/ acute hepatitis B or who is a chronic carrier
41
Q

What are some non-pharms for hep B prevention?

A
  • All chronic HBV patients should be educated to prevent viral transmission
  • Sexual and household contacts require vaccination
  • Chronic HBV px should avoid alcohol and get immunized against HAV to prevent further liver damage
42
Q

What is the dosing for the hep A and hep B combination vaccine?

A

IM injection at month 0, 1, and 6

43
Q

How is hep C transmitted?

A
  • Blood borne
  • Sexual contact
  • Perinatal transmission from mother to child
44
Q

What are risk factors for HCV?

A
  • Injection drug use
  • Blood transfusion
  • Healthcare associated transmission (rare)
  • Prisoners, homeless, IV drug users are high risk
45
Q

What are the sx of acute hep C?

A
  • Most asymptomatic

- Sx may include anorexia, abdominal pain, fatigue, nausea, dark urine, jaundice

46
Q

Can acute hep C turn into a chronic infection?

A

Yes, in up to 85% of px

47
Q

What can chronic HCV cause?

A

Cirrhosis and hepatocellular cancer, leading to liver transplant

48
Q

What is the tx for hep C?

A

Oral regiment w/ duration of 6-12 weeks or up to 24-48 weeks

- High cure rate (>90%)

49
Q

What are some non-pharms for tx of hep C?

A
  • Chronic HCV px should vaccinate against hep A and B
  • Avoid alcohol
  • Eat well balanced diet
  • Exercise regularly
  • Avoid smoking

Clinical - Winter (24 decks)

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