Dental aspect Hepatitis Flashcards

1
Q

What pathogens can induce Hepatitis?

A

Epstein Barr Virus

Hepatitis ABC

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2
Q

What relevant drug reactions must we be aware of in regards to in hepatitis

A

Paracetamol

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3
Q

What are the idea and damaging doses of paracetamol?

A
4g max (8 tabs) in 24 hours
10-15g (20-30 tabs) acute liver damage 
25g (50 tabs) invariably fatal
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4
Q

Other than pharmacological and pathogenic, what are other causes of hepatitis?

A

Autoimmune
Wilson’s disease- Genetic disorder causing accumulation of COPPER (notice brown K-F ring around eye)
Toxins

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5
Q

What are the characteristics of acute hepatitis?

A

Self-limiting inflammation

Similar indications of heptitis

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6
Q

What drugs must we be wary of in regards to hepatitis?

A

Erythromycin- Due to impaired excretion from liver to bile and risk of elevating liver enzymes. THEREFORE HEPATOXIC

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7
Q

How can we investigate for hepatitis?

A
LFTs test (liver enzymes) 
Causation tests i.e. viral serology (pathological), immunoglobulins, auto antibody profile
Liver ultrasonography
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8
Q

What are the indications of Chronic Liver Disease?

A

CIRRHOSIS commonly caused by Hep c or Alcohol
Liver fibrosis
Reduced liver mass
Portal hypertension

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9
Q

What can Cirrhosis lead to?

A

Portal hypertension- this can lead to varicose veins of the lower oesophagus.
These can rupture and bleed

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10
Q

What conditions are associated with a reduced Liver mass?

A

Encephalopathy- inability to metabolise ammonia containing compounds FLAPPING TREMOR
Reduced attention span- Due to ammonia build up on brain
Reverse Sleeping pattern

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11
Q

What symptoms and considerations must be made with chronic liver disease?

A

Loss of lean body mass i.e. shoulders
Accumulation of body water
COAGULOPATHY PROBLEMS *(FACTORS 1, 2, 10 AND 12)

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12
Q

What history items can indicate Hepatitis?

A

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

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13
Q

Indication of jaundice?

A

Yellowness of the Sclera of the eye- PULL DOWN eyelid if you are uncertain

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14
Q

Indication of bruising and spider naevi?

A

Dark spots due to easy internal bleeding

SN- Central red spot with spindle like projections- Will disappear under pressure

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15
Q

Indication of ASTERIXIS?

A

The liver flap

Where hand is extended, the digits of fingers flap

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16
Q

Indication of increased Bile salts?

A

Bile Salts are irritants and excreted through sweat.

Causes patient to SCRATCH.

17
Q

Indication of Sialosis?

A

Non inflammatory, Non neoplastic enlargements

18
Q

Indication of DUPUYTREN’S CONTRACTURE/

A

Ring finger flexed due to tightening of the fascia

19
Q

Indication of Palmer Erythema?

A

Red Palms due to

20
Q

Indications of Gynaecomastia?

A

Production of mammary tissues in males DUE TO LACK OF METABOLISM FOR OESTROGEN

21
Q

What are the main liver function tests?

A

ALT
AST
Clotting
Gamma Glutamyl transpeptidase- specific for alcohol induced
Alkaline Phosphatase (FOR LIVER AND BONE ACTIVITY) Non specific

22
Q

What would be the most appropriate course of management be with patients indicated with hepatitis and bleeding?

A

ACCESS TO FULL BLOOD COUNT AND CLOTTING SCREEN.

This would be a good indication to refer to secondary care