Acute Hepatitis Flashcards
What is acute hepatitis?
Acute onset of inflammation in the liver caused by multiple things
What histological signs are there? (5)
Hepatocyte swelling, cytoplasmic granularity, vacuolation, necrosis, shrinking
Where does necrosis normally occur in the liver?
Zone3
What is spotty/focal necrosis?
When small areas of hepatocytes die throughout the liver
What is multiacinar necrosis?
Substantial necrosis throughout the liver
What signs can be seen in cirrhosis? (3)
Confluent necrosis with collapse of reticulin framework resulting in bridging of central veins and portal tracts
What are the viral causes? (8)
Hep A, B, C, D, E, Epstein Barr Virus, CMV and Yellow fever
What are the Bacterial causes? (2)
Toxoplasma Gondii, Coxiella Burnetti
What other causes are there? (4)
Poisons (aflatoxin, mushrooms), Drugs (paracetamol), Pregnancy, Wilson’s Disease
Symptoms (4)
May be asymptomatic, Malaise, fever, anorexia
Signs (5)
Jaundice, hepatomegaly, pale stools, dark urine, urticarial rash
What bloods would you do? (4)
LFTs, FBC, ESR, Prothrombin Time
Other investigations (2)
Liver ultrasound, Liver Biopsy
Treatment
Antivirals if viral, antibiotics if bacterial, Acetyl Cysteine if Paracetamol Overdose
Reduce Alcohol, fluids, anti-emetics
