Dental aspect Hepatitis Flashcards
What pathogens can induce Hepatitis?
Epstein Barr Virus
Hepatitis ABC
What relevant drug reactions must we be aware of in regards to in hepatitis
Paracetamol
What are the idea and damaging doses of paracetamol?
4g max (8 tabs) in 24 hours 10-15g (20-30 tabs) acute liver damage 25g (50 tabs) invariably fatal
Other than pharmacological and pathogenic, what are other causes of hepatitis?
Autoimmune
Wilson’s disease- Genetic disorder causing accumulation of COPPER (notice brown K-F ring around eye)
Toxins
What are the characteristics of acute hepatitis?
Self-limiting inflammation
Similar indications of heptitis
What drugs must we be wary of in regards to hepatitis?
Erythromycin- Due to impaired excretion from liver to bile and risk of elevating liver enzymes. THEREFORE HEPATOXIC
How can we investigate for hepatitis?
LFTs test (liver enzymes) Causation tests i.e. viral serology (pathological), immunoglobulins, auto antibody profile Liver ultrasonography
What are the indications of Chronic Liver Disease?
CIRRHOSIS commonly caused by Hep c or Alcohol
Liver fibrosis
Reduced liver mass
Portal hypertension
What can Cirrhosis lead to?
Portal hypertension- this can lead to varicose veins of the lower oesophagus.
These can rupture and bleed
What conditions are associated with a reduced Liver mass?
Encephalopathy- inability to metabolise ammonia containing compounds FLAPPING TREMOR
Reduced attention span- Due to ammonia build up on brain
Reverse Sleeping pattern
What symptoms and considerations must be made with chronic liver disease?
Loss of lean body mass i.e. shoulders
Accumulation of body water
COAGULOPATHY PROBLEMS *(FACTORS 1, 2, 10 AND 12)
What history items can indicate Hepatitis?
Jaundice- impaired function
Alcohol Intake-
Infections
Drug intolerance- Indicates issues in liver enzymes
Bleeding disorders - indicating clotting issues
IVDU
Sexual History- high risk groups such as LGBT and Prostitutes
Indication of jaundice?
Yellowness of the Sclera of the eye- PULL DOWN eyelid if you are uncertain
Indication of bruising and spider naevi?
Dark spots due to easy internal bleeding
SN- Central red spot with spindle like projections- Will disappear under pressure
Indication of ASTERIXIS?
The liver flap
Where hand is extended, the digits of fingers flap