Disorders of the Liver Part 2 COPY Flashcards
Which hepatitis is fecal-oral?
Hep A
Which Hep is blood-borne?
Hep B and C and D
D is associated with B only!
What kind of virus is Hep A?
RNA
What is unique about having Hep A?
There is no chronic carrier state.
How does Hep A typically present?
- Worse in adults
- Distaste for smoking
- Low grade fever
- Malaise, arthralgia, URI, fatigued
- Mild constant abdominal pain in RUQ aggravated by exertion/jarring
When does jaundice tend to occur in Hep A?
5-10 days after
What kind of stool is Hep A?
Acholic (mashed potatoes?)
Who should we suspect Hep A infection in?
- Abrupt onset of prodromal symptoms (N, anorexia, fever, malaise, or abd pain)
- Jaundice
- Elevated aminotransferase levels
How is a Hep A diagnosis established?
IgM anti-HAV antibodies
What is the best indicator of a previous exposure, non-infectivity, and immunity of hep A?
IgG
What is the ALT/AST ratio in Hep A?
ALT > AST
What does a blood smear look like for Hep A?
Atypical large lymphocytes
How do you treat and prevent hep A?
- Treatment: rest and fluids, avoid exertion
- Prevention: VACCINATION, washing hands, can get shot if you get exposed.
What are the essentials of diagnosis of Hep A?
- Infection acquired via fecal-oral route and is self-limited
- Relapsing infection and protracted cholestatic phase
- IgM antibody test
- IgG development leads to protection and lifelong immunity
What are the components of the Hep B virus?
- Inner core: HBcAg and HBeAg
- Outer surface: HBsAg
8 different genotypes as a result! 2^3
HBcAg = Hep B core antigen
HBeAg = Hep B e antigen
HBsAg = Hep B surface antigen
How is Hep B transmitted and prevented?
- Transmission: Blood-borne and sexual intercourse
- Prevention: VACCINATION
Who are the greatest risk factors for Hep B?
- MSM
- Hemodialysis center staff and pts
- Clinical pathology and blood banks
- STD or incarcerated
How long does it take Hep B to incubate?
6 weeks to 6 months
How does Hep B infection typically present?
- Losing your appetite
- Jaundice
- Fever
- Dark urine
- Pale poop
- N/V
- RUQ pain
- Joint pain
What are the serologic markers for Hep B?
- HBsAg
- Anti-HBs
- Anti-HBc
- HBeAg
What is the FIRST serologic marker to elevate in Hep B?
HBsAG
Past 6 months of elevation = chronic
What serologic marker changes suggest recovery from an acute Hep B infection?
- Anti-HBs appearance
- HBsAG Decrease
What serologic marker changes suggest Hep B immunity?
- Anti-HBs persistence
- No elevated HBsAG
When does IgM anti-HBc tend to appear in a Hep B infection?
1 month after HBsAG appears