39 - Viral Infections of the GI Tract I Flashcards
What is hepatitis?
A disease marked by inflammation of the liver
What are the three main clinical presentations of hepatitis?
- Acute hepatitis
- Chronic hepatitis
- Fulminant hepatitis
What are the symptoms of acute viral hepatitis?
- Jaundice
- Dark urine
- Alcoholic stool
- Prodrome
What is “alcoholic stool”?
A light or clay-colored stool due to reduction in bile production
What is prodrome?
1-2 weeks prior to jaundice
- Headache
- Myalgia
- Arthralgia
- Fatigue
- Nausea
- Vomiting
- Pharyngitis
- Mild fever
Why do we see jaundice?
Because bilirubin is not properly recycled, so it is elevated in the body
What do we define jaundice as?
More that 3 mg/dL of bilirubin
What does bilirubin in the urine indicate?
Liver disease
What liver enzymes will be elevated in hepatitis?
ALT: alanine aminotransferase
AST: aspartate aminotransferase
When will these enzymes become elevated?
In the prodrome phase
Are these enzymes typically more elevated in a viral infection or in hepatitis from alcoholism, etc.?
Higher in viral infection
How do we define chronic viral hepatitis?
- Hepatitis which does not resolve within 6 months
What does chronic viral hepatitis predispose individuals to?
Hepatocellular carcinoma and cirrhosis
What phases would someone in chronic viral hepatitis go through?
There is damage, but also regeneration, so you can go through phases of better and worse
What is fulminant viral hepatitis?
Rapid and severe hepatitis which results in massive hepatic necrosis
What else does fulminant viral hepatitis cause?
- Encephalopathy
- Edema
- GI bleeding
- Sepsis
- Organ failure
What does the encephalopathy cause?
CNS effects
- Confusion
- Disorientation
- Coma
Cerebral edema can compress the brainstem
What is something that can be lifesaving to patients with fulminant viral hepatitis?
Liver transplant
What are the five types of hepatitis?
Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E
What virus family is Hepatitis A from?
Picornavirus
What is the invubation period for Hepatitis A?
2-4 weeks
What is the transmission type for both Hepatitis A and Hepatitis E?
Fecal-oral route
What else do Hepatitis A and Hepatitis E have in common?
Neither can cause a chronic infection
What is the virus family for Hepatitis B?
Hepadnavirus
What is the incubation period for Hepatitis B?
6 weeks to 6 months
What type of transmission do we see for Hepatitis B, Hepatitis C and Hepatitis D?
Body fluids
What else do Hepatitis B, Hepatitis C, and Hepatitis D have in common?
They can cause a chronic infection
What virus family is Hepatitis C from?
Flavivirus
What is the incubation period for Hepatitis C?
2 months
What is the virus family for Hepatitis D?
Deltavirus
What is the incubation period for Hepatitis D?
2 to 12 weeks
What is the virus family for Hepatitis E?
Hepevirus
What is the incubation period for Hepatitis E?
6 to 8 weeks
Which Hepatitis virus is the ONLY one with a DNA genome?
Hepatitis B
All the others have a RNA genome
What age groups are most susceptible to Hepatitis A?
All age groups
Children are usually asymptomatic
How long does it typically take to resolve an infection from Hepatitis A?
2 months