Acute hepatitis Flashcards

1
Q

What is acute hepatitis

A

Inflammation of the liver –> acute parenchymal liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many people are affected by Hep B

A

1 mil/year - IV drug users, health workers, haemophiliacs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What causes acute hepatitis

A

Viral Hep A-E

  • Hep A (RNA) - most common cause ACUTE –> never causes cirrhosis
  • Vaccination for Hep A+B
  • hep C - no vaccine - IVDU
  • Hep D - only in those w Hep B

Alcoholic hepatitis
- eventually cirrhosis

Drug induced
- Paracetamol overdose, TB Abx (rifampicin, isoniziad), statins, sodium valproate, halothane, MAOIs

Ischaemic hepatitis

  • ass HF, shock, sepsis
  • Bloods = high AST + ALT

Infectious mononucleosis, CMV, herpes, toxoplasmosis, yellow fever, WIlsons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the pathophysiology of acute hepatitis

A
  • Degenerative changes –> swelling, cytoplasmic granularity –> necrosis
  • Collapse of reticulin framework between central veins
  • Lobules infiltrated by lymphocytes
  • fatty changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the risk factors for hepatitis

A
  • Vertical transmission for Hep B
  • Drug users, tattooists or acupuncturists
  • male sex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the symptoms of acute hepatitis

A
  • Non-specific, flu like initially
  • -> fever, headache, myalgia, N+V, diarrhoea, headache
  • Loss of appetite
  • Aversion to smoking
  • Abdo discomfort

AFTER 2 WEEKS
- Jaundice, vom, nausea, mental confusion

Hep C mostly asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the signs of acute hepatitis

A
  • Dark urine + pale stools (intrahepatic cholestasis)
  • Tender lymphadenopathy
  • Transient rash
  • Hep B: resembles Hep A but extrahepatic signs more common – arthralgia, urticarial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the investigations for acute hepatitis

A

Bloods
o Raised AST & ALT & LDH (lactate dehydrogenase)
o Prolonged PT

Hep B surface antigen test

Test for alpha 1 antitrypsin deficiency –> ++ protein in liver can –> inflammation

Leucopenia.
PT is prolonged.
ESR raised.
IgG for hepatitis A, B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you treat hepatitis

A
  • Hep A - no spec Tx
  • Hep B - symptomatic Tx
  • Hep C - interferon used to prevent chronic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the prognosis

A
  • Hep A - excellent
  • Hep B - variable - flare ups, hepatocellular carcinoma risk high
  • Hep C - 85-90% asymptomatic - develop chronic liver disease –> cirrhosis in 20-80%
  • Hep D = poor - 70% get cirrhosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly