6.8 Liver Dysfunction Flashcards
Hepatitis A
Spread
Risk factors
Clinical pattern
Spread: Faeco-oral route
-Contaminated food
- Sea water (+live oysters)
- Dried faesies 4 weeks
NO CARRIER STATE
Risk Factors: Healthy individual (travels, occupation, contact, adoption), MSM, HIV+, Chronic liver disease, clotting factor disorder, Drug-addicts
Clinical pattern
1. Asym w/o jaundice
2. Sym with juandice (8 weeks)
3. Cholestatic w jaundice (>10 weeks)
4. Relapse (2x in 6-10 weeks)
5. Acute liver fail
Hepatitis B
Pathogenesis
What is it a risk for
Transmission
Influencing factors
Pathogenesis
-Reverse transcription / DNA polymerase
What is it a risk for
- End stage liver disease
- Cirrhosis
- Liver Fail
Transmission
-Horizontal
- Vertical (Mother to child) -> breastfeeding
Influencing factors
- HBV DNA levels
- Gender
- Alcohol
- Age
- Immune status
- Co-infect (increase VL of Hep B)
Hepatitis c
Pathogenesis
Transmission
Pathogenesis
- Main cause of chronic liver disease
- Doesn’t incorporate into nucleus
Transmission
- Parenteral (not in mouth): Blood, drug users, Needle stick injury
- Non-parenteral (in mouth): MTCT, Sexual
Where do you find Hep D?
Unique nuclear antigen in hepatocytes of pt infected with Hep B
Acute liver Failure
Causes
- Drugs + Toxin (paracetamol)
- Virus (Hep A, B, E)
- Vascular
- Malignancies
- Metabolic
- Pregnancy (HELLP, Hyperemesis gravidarum)
- Miscellaneous (heatstroke)
Grades of Hepatic Encephalopathy (cerebral oedema)
Grade 1 - Altered sleep pattern
Grade 2 - Behave change, asterixis (flapping hands)
Grade 3 - Somnolence to semistupor (excessive sleepiness)
Grade 4 - Coma
Chronic liver Disease
Causes of cirrhosis
Complications
**Causes of cirrhosis*:
-Viral (Hep B, C, D)
- Autoimmune
- Toxic (Alcohol)
- Metabolic
- Vascular
- Biliary
- Genetic
- Iatrogenetic
- Prehepatic
- Intrahepatic
- Posthepatic
Complications:
- Ascites
- Spontaneous bac peritonitis
- Hepatorenal syn
- Variceal haemorrhage
- Hepatic encephalopathy
