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NUR 326 > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

hepatitis

A

Systemic virus that affects the liver
Inflammation of the liver

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2
Q

what are the types of hepatitis?

A

A, B, C

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3
Q

Which types of the most common?

A

B, C

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4
Q

Pathogenesis of hepatitis

A

viral infection
Immune response – inflammatory mediators
Lysis of infected cells
Edema/swelling of tissue
Tissue hypoxia
hepatocyte death

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5
Q

s/sx hepatitis

A

many cases are asymptomatic

Causes abnormal increased LFTs, but not consistent with cell damage within liver

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6
Q

Prodromal phase

A

two weeks after exposure

fatigue, anorexia, malaise, N/V, headache, hyper algesia, cough, low-grade fever

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7
Q

T/F the prodromal phase is highly transmissible

A

True

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8
Q

icteric phase

A

begins with jaundice
2 to 6 weeks, active phase

Dark urine, clay, colored stool, enlarged liver, painful to palpate, fatigue, abdominal pain, persists

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9
Q

Which phase is considered the active phase of hepatitis?

A

Icteric

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10
Q

Recovery phase

A

resolution of jaundice
6 to 8 weeks after exposure, symptoms decrease

Enlarged liver/tender

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11
Q

complications of hepatitis

A

higher mortality in elderly and comorbidities
Chronic hepatitis
Liver cirrhosis
Liver cancer
Fulminate viral hepatitis – acute liver failure

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12
Q

hepatitis A transmission

A

Fecal – oral, IV , sexual
Foodborne illness, poor sanitation

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13
Q

s/sx hepatitis A

A

Acute onset, fever, mild severity

fatigue, fever
N/V/D, pale poop
Stomach pain, no appetite
Dark urine, jaundice

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14
Q

Can hepatitis A develop into chronic hepatitis?

A

no

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15
Q

Prevention of hepatitis A

A

hand hygiene
Vaccine – high risk exposure

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16
Q

hepatitis B transmission

A

IV. Drug use, sexual

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17
Q

is hepatitis B, a acute or insidious onset?

A

Insidious onset, long incubation Period

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18
Q

prevention of hepatitis B

A

Vaccine
Safe sex
Hygiene

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19
Q

hepatitis C transmission

A

IV. Drug use, sexual, mother fetal

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20
Q

T/F hepatitis C is an acute onset

A

False, insidious onset

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21
Q

can hepatitis C become chronic

A

Yes, leads to hepatocellular carcinoma

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22
Q

prevention of hepatitis C

A

Screening blood, hygiene

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23
Q

T/F there is no vaccine for hepatitis C

A

True

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24
Q

Hep A vaccine series

A

two doses, six months apart

All children over one year, high-risk populations

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25
Q

hep B vaccine series

A

Three doses, four months apart
All infants beginning as newborns

26
Q

what are disadvantages of hepatitis treatment?

A

Prolonged therapy
Cost
Lots of side effects
High relapse

27
Q

Direct acting antiviral therapy

A

Drug therapy for chronic hepatitis C

28
Q

what is the max Tylenol dosage for chronic hepatitis patients?

A

2 g per day

29
Q

Cirrhosis

A

scarring of liver, fibrotic liver disease

30
Q

T/F cirrhosis is reversible

A

False it is irreversible

31
Q

Patho of cirrhosis

A

not well understood

Structural changes from injury – alcohol/viruses and fibrosis

32
Q

Patho of chronic fibrosis

A

Obstructive biliary channels and blood flow – jaundice, portal HTN

Regeneration interrupted by hypoxia, necrosis, atrophy, and liver failure

33
Q

fibrosis

A

Infiltration of WBC – leukocytes
Release, inflammatory mediators in response to fibrotic process

34
Q

How long does cirrhosis occur?

A

Slowly over years

35
Q

Causes of fibrosis

A

Alcohol/metabolites – rate depends on amount present

36
Q

can the removal of toxins reverse fibrosis?

A

No, but it can slow the progression

37
Q

causes of cirrhosis

A

Hepatitis B and C
Excessive alcohol intake
Idiopathic **

38
Q

How does alcoholism affect liver disease?

A

Inhibits exports from the liver, alterations in metabolism of vitamins and minerals and induces mount nutrition

39
Q

what is the most common type of cirrhosis?

A

Alcohol cirrhosis

40
Q

alcohol fatty liver

A

Fatty deposits cause lipogenesis
Reversible
mild, asymptomatic

41
Q

alcoholic streatohepatisis

A

Precursor to cirrhosis
Inflammation/degeneration of hepatocytes
Becomes irreversible

Anorexia, jaundice

42
Q

alcoholic cirrhosis

A

Fibrosis in scarring altering liver structure
Irreversible

43
Q

T/F alcoholic streatohepatitis is reversible

A

False

44
Q

pathogenesis of liver disease

A

Liver cells destroyed
Cells try to regenerate
Disorganized process
Abnormal growth
Poor blood flow/scar tissue
Hypoxia
Liver failure

45
Q

stages of liver damage

A

Healthy liver
Fatty liver
Liver fibrosis
Cirrhosis

46
Q

s/sx liver disease

A

G.I. disturbances– N/V, anorexia, gas, change in bowel habits

Fever, weight, loss, palpable liver

47
Q

late s/sx of liver disease

A

jaundice, peripheral edema
Endocrine problems
Hematologic problem- anemia, bleeding
Decreased albumin and protein
ascites, skin lesions– spider
Encephalopathy
Esophageal and Anorectal varices

48
Q

portal HTN

A

Resistant portal blood flow – varices and ascites

49
Q

causes of portal HTN

A

systemic hypotension
Vascular underfilling
Stimulation of RAAS system
Plasma volume expansion
Increase cardiac output

50
Q

What causes portal HTN to go from asymptomatic to symptomatic?

A

complications
variceal hemorrhage, ascites, hepatorenal syndrome, cardiomyopathy, peritonitis

51
Q

Treatment for portal HTN

A

Liver transplant

52
Q

what is the primary driver to diagnose hepatic encephalopathy?

A

Level of consciousness

53
Q

what determines the severity of hepatic encephalopathy?

A

The grade – minimal, one, two, three, four

54
Q

T/F ammonia levels correlate with hepatic encephalopathy

A

True, toxins build up in the brain

55
Q

Cause of fulminant/acute liver failure

A

Most common– acetaminophen overdose

56
Q

T/F acute liver failure is caused by cirrhosis and fibrosis

A

False, it is not

57
Q

Patho of acute liver failure

A

edematous hepatocytes and patchy areas of necrosis
Inflammatory cell infiltrates and disrupts liver tissue

58
Q

treatment for acute liver failure

A

Liver transplant

59
Q

when does acute liver failure occur?

A

6-8 weeks after viral, hepatitis/metabolic liver disease

5 days to 8 weeks after overdose

60
Q

How can the acetaminophen overdose be treated?

A

Acetylcysteine

NUR 326 (32 decks)

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