hep

Question 1

2 hep that is acute

hep that is acute and chronic

hep conjuncts with B

hep that is usually just chronic, rarely acute

Answer 1

acute: Hep A E

acute & chronic: Hep B

conjuncts with B : Hep D

chronic: C

Question 2

other causes of hepatitis

Answer 2

Epstein-Barr Virus (EBV, Mononucleosis) and Cytomegalovirus (CMV)

Question 3

testing for Hep A, B, C

Answer 3

Hepatitis A: anti-HAV IgM - acute infection (if reactive then anti-HAV total or IgG- for immunity)

Hepatitis B: HBsAg, (if reactive then anti-HBc total)

Hepatitis C: anti-HCV

Question 4

Suspect acute hepatitis s/s : 5

Answer 4

nausea
vomiting
jaundice,
anorexia
elevated ALT

Question 5

Does my patient have immunity to hepatitis A? order?

Does my patient have immunity to hepatitis B? order?

Answer 5

A: anti-HAV total or anti- HAV IgG

B: anti-HBs

Question 6

anti-HAV IgM positive?

anti-HAV total or anti-HAV IgG positive?

Answer 6

acute infection of Hep A

immunity to Hep A from natural or

Question 7

• anti-HCV?

need what to confirm active infection?

Answer 7

• Indicates exposure to hepatitis C. Does not imply immunity,

active infection confirms by HCV RNA.

Question 8

HBsAg

anti-HBs

resolved Hep B infection? 3

Answer 8

HBsAg - hep b infection, active

anti-HBs- Immunity to hepatitis B, due to vaccination or natural infection

both anti-HBc total and anti-HBs reactive (and HBsAg is non-reactive)

Question 9

which Hep viruses Entry via the GI tract: 2

what route? and travels to liver how?

replicates where, excreted where, shed where?

Answer 9

hepatitis A and E

fecal – oral route to GI tract via hepatic portal vein to the liver

replicates in liver,
excreted in the bile shed in the stool (= fecal shedding)

Question 10

which hep viruses Entry via the blood: 3

via what route?

travels to liver how?

replicates where, shed/release where?

Answer 10

hepatitis B, C, and D

transmitted via infected blood
low levels in body fluids such as semen, vaginal secretions, and saliva

the virus enters the blood travels via the hepatic artery to the liver

replicates in liver released into the blood

Question 11

3 hep not spontaneously cleared

Answer 11

B, C, D

cirrhosis, hepatocellular carcinoma

Question 12

Fulminant hepatitis

Answer 12

massive hepatic necrosis, leading to acute liver failure in weeks
rare, fatal, requires transplantation

Question 13

3 things decreased in Splenomegaly

Answer 13

Splenomegaly - decreased RBC, WBC, platelets

Question 14

which hep np can tx indep

cure for hep b? drugs? np prescsribe? how long use?

Answer 14

a

no

NPs cannot prescribe medications for Hep B
Current approved treatments are:
interferon injections (for up to 48 weeks)
lamuvidine, tenofivir, entecavir (oral)
used indefinitely

Question 15

if liver cirroshis, avoid what drug? risk for?

Answer 15

NSAIDS, risk for acute renal dysf