Acute Hepatitis Flashcards
Hepatitis
Liver inflammation
Most common etiologies for Acute Hepatitis?
Viral infection
Medications
Most common symptoms for Acute Hepatitis?
RUQ pain and hepatomegaly
N/V and Jaundice
Dark urine and Acholic stools
What is Acute Fulminant Liver Failure?
Massive hepatic necrosis with impaired consciousness within 8 weeks of onset of illness
What is the #1 cause of Acute Fulminant Liver Failure?
Acetaminophen overdose (APAP)
Sign/Symptoms of Acute Fulminant Liver Failure?
Rapidly SHRINKING liver
Confusion
Edema, Jaundice, pruritus, N/V
Symptoms of Acute Fulminant Liver Failure?
Rapidly SHRINKING liver
Confusion
Edema, Jaundice, pruritus, N/V
Describe the progression of the labs with Acute Fulminant Liver Failure as the liver fails
- ELEVATED AST/ALT
- ELEVATED bilirubin and prolonged PT/INR
- DECREASED AST/ALT
If Acetaminophen causes Acute Fulminant Liver Failure, above what number will the AST/ALT likely be?
> 5000
2 possible complications of Acute Fulminant Liver Failure?
- Cerebral/brainstem compression
- Sepsis and multi-organ failure
What is the treatment for Acetaminophen overdose?
N-Acetylcysteine
Liver transplant
What Nomogram should be used to find out Acetaminophen level?
Rumak - Matthew
Viral Hepatitis A
RNA virus
Fecal-oral spread
ACUTE
Viral Hepatitis A is more severe in ____
Adults
Is there a vaccine available for Hepatitis A?
YES
Labs with Hepatitis A?
Increased bilirubin and alkaline phosphatase
Increased AST/ALT
Treatment for Hepatitis A?
Supportive; self-limited
Viral Hepatitis B
DNA virus
Blood/sex/mother to baby spread
Usually ACUTE (some chronic)
What extra symptom may be seen with Hepatitis B?
Cutaneous Polyarteritis Nodosa
Cutaneous Polyarteritis Nodosa is seen with?
Hepatitis B
Labs with Hepatitis B?
Increased AST/ALT
Prolonged PT/INR – bleeding risk
Hepatitis B has a window period. What is that?
Time between when the HBsAg has disappeared and the HBsAb has appeared
– weeks to months
Hepatitis B has a window period. What is that?
Time between when the HBsAg has disappeared and the HBsAb has appeared
– weeks to months
During the Window period with Hepatitis B, the patient is considered to have?
ACUTE hepatitis B!
During the Window period with Hepatitis B, the patient has Acute Hepatitis B, what test will be (+)?
IgM
Is there a vaccine available for Hepatitis B?
YES
Viral Hepatitis D requires?
Hepatitis B infection!!
What will be (+) with Hepatitis D?
HDV RNA PCR
How do you protect against Hepatitis D?
Vaccinate against Hepatitis B
Hepatitis D enhances severity of?
Hepatitis B infection
Viral Hepatitis C
RNA
Blood/needle spread
CHRONIC
Symptoms of Hepatitis C?
Mild and Asymptomatic
Labs with Hepatitis C?
FLUCTUATING AST/ALT
Fluctuating AST/ALT is seen with?
Hepatitis C
(+) HCV RNA or Ab can diagnose Hepatitis C. If there are Anti-HCV in the serum but NO RNA, what does that mean?
Prior infection
Is there a vaccine available for Hepatitis C?
NO
Complications of Hepatitis C?
Cirrhosis
Mixed Cryoglobulinemia
Hepatocellular Carcinoma
What is the recommended prevention for Hepatitis C?
- Screen baby boomers and those over 18, along with blood products
- Do not share toothbrush or razor if infected
Viral Hepatitis E
RNA
Fecal-oral (swine) spread
ACUTE or CHRONIC if immunocompromised
When will Viral Hepatitis E be Chronic?
In immunocompromised patients
When will Hepatitis E progress from Chronic to Cirrhosis?
In transplant patients on Tacrolimus
When can Fulminant Hepatitis E occur?
In pregnant patients
Is there a vaccine available for Hepatitis E?
NO
In what Hepatitis’s is there vaccines available?
A and B
Symptoms of Acute Hepatitis?
RUQ pain, Hepatomegaly
Jaundice and N/V
Dark urine and Acholic stool
