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NURS 320 > Exam 2: Hepatitis And Acute Liver Failure > Flashcards

Exam 2: Hepatitis And Acute Liver Failure Flashcards

1
Q

Hepatitis

A

Inflammation of liver that can result in cell damage and liver dysfunction

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2
Q

Hepatitis can be caused by

A

Alcohol abuse
Medications
Viruses

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3
Q

Hepatitis can be

A

Acute or chronic

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4
Q

Viral Hepatitis

A

Relatively common
Primarily affects liver
Different strains of viruses cause different types of hepatitis (A-E+)

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5
Q

Hepatitis: Pathologic Lesions include

A

Hepatic cell necrosis
Scarring (with chronic disease)
Kupffer cell hyperplasia

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6
Q

Hepatitis A (HAV) injury to hepatocyte is cause by

A

Host cell’s immune response

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7
Q

Hepatitis B

A

Milder than Hep C, but can lead to chronic hepatitis or liver failure and death

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8
Q

Transmission of Hepatitis B occurs through

A

blood and body fluid exposure, maternal-baby exchange.

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9
Q

Antiviral drugs therapy for hepatitis B include but are not limited to

A

Telbivudine (Tyzeka)

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10
Q

Telbivudine (Tyzeka)

A

Nucleoside analogue reverse transcriptase inhibitor

Treatment of Hepatitis B

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11
Q

Telbivudine (Tyzeka): Adverse Effects

A

fatigue, headache, diarrhea, nausea, pain in joint and muscles

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12
Q

Telbivudine (Tyzeka): Interactions

A

alpha-interferons (cause severe peripheral neuropathy)

Caution: Nephrotoxic drugs

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13
Q

Dosage adjustments of Telbivudine (Tyzeka) is need in patients with

A

Renal insufficiency

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14
Q

Hepatitis C

A

Leading cause of liver failure leading to liver transplantation
Symptoms initially mild, but lead to chronic

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15
Q

Hepatitis C: Transmission

A

Infected blood and sexual contact.

Alcoholic disease can lead to development of hepatitis C.

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16
Q

Hepatitis C: Treatment

A
  • interferon (family of naturally-occurring proteins that are made and secreted by cells of the immune system; modulate the response of the immune system to viruses and cancer)
  • ribavirin (Virazole)
  • simeprevir (Olysio)
  • sofosbuvir (Solvaldi)
17
Q

Ribavarin (Virazole)

A

Given orally, or by oral or nasal inhalation
Inhalation form (Virazole) used for hospitalized infants with respiratory syncytial virus (RSV) infections
Pregnancy X drug, inhalation form can’t be given by pregnant healthcare provider.

18
Q

Ribavarin (Virazole): MOA

A

Synthetic nucleoside analog
Works with RNA and DNA synthesis
Inhibits protein synthesis AND viral replication

19
Q

Sofosbuvir (Solvaldi)

A 
First-in-class RNA polymerase inhibitor for the treatment of chronic hepatitis C
Sofosbuvir is considered “break-through” therapy.
First drug treatment for hepatitis C that can be given without interferon
20
Q

Sofosbuvir (Solvaldi): Side Effects

A

Few side effects (fatigue, headache, nausea, difficulty sleeping).
When taken with amiodarone (Cordarone or Pacerone) may cause slow heart rate which can lead to death.

21
Q

Sofosbuvir (Solvaldi) used in

A

Combination with ribavarin (Varizole).

Not to be used as mono therapy.

22
Q

Simeprevir (Olysio)

A

Protease inhibitor (PI)
Chronic hepatitis C
Approved in 2013
Pregnancy C, but when combined with interferon and ribavirin (Virazole) = Cat X

23
Q

Simeprevir (Olysio): Used in

A

Conjunction with standard hepatitis C treatments: interferon and ribavirin (Virazole).
Not to be used as monotherapy.

24
Q

Simeprevir (Olysio): Adverse Effects

A

Photosensitivity
Rash
Nausea
Pruritus

25
Q

Acute Liver Failure

A

Severe impairment or necrosis of liver cells without preexisting liver disease or cirrhosis.
Rare

26
Q

Acute Liver Failure: Causes

A 
Acetaminophen overdose (most common)
Viral hepatitis (particularly Hepatitis B)
Compound infection of delta virus
Metabolic liver disorder
27
Q

Acute Liver Failure Pathophysiology

A

Edematous hepatocytes + patchy areas of necrosis + inflammatory cell infiltrates = disruption of the functional tissue of the liver (parenchyma)

28
Q

Acute Liver Failure usually develops

A

6-8 weeks after the initial symptoms of viral hepatitis or metabolic liver disorder.
5 days-8 weeks after acetaminophen overdose.

29
Q

Acute Liver Failure Symptoms

A

Anorexia
Vomiting
Abdominal pain
Progressive jaundice

30
Q

Acute Liver Failure can lead to

A

Leads to ascites, GI bleeding -> which can lead to hepatic encephalopathy (lethargy, altered motor function) -> Coma (cerebral edema, ischemia, and brainstem herniation)
Renal failure and pulmonary distress can occur

31
Q

Acute Liver Failure Lab Findings

A

Increased direct and indirect serum bilirubin
Increased serum transaminases
Increased blood ammonia
Increased prothrombin time

32
Q

Acute Liver Failure Treatment

A
  • Irreversible (60-90% of children die)
  • Rapid evaluation and critical care and support: airway, circulation, hemodynamics; infection control; acetylcysteine for acetaminophen overdose; monitor labs and assess for GI bleeding; nutrition (patient should be NPO)
  • Liver Transplant

NURS 320 (28 decks)

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