Hepatitis Flashcards
List four general symptoms associated with viral hepatitis
Fatigue, myalgia, loss of appetite, nausea, diarrhea, constipation, fever, jaundice
T/F
Physicians/PAs are able to differentially diagnose cases of viral hepatitis based on Sx alone
F
How are liver function tests used in the diagnosis of viral hepatitis?
A. To indicate status of liver function B. To indicate roughly the amount of liver damage C. To indicate the viral agent involved D. Two of the above E. All of the above
D (A and B)
A 26 y.o. daycare teacher felt fatigued, had diarrhea, and was running a fever. Assuming it was just the flu, she rested for a couple of days. When symptoms continued for more than a week, she came to you. Aside from the sx above, she also tells you that her stools have changed color. When examining her sclera, you note that the patient is jaundiced. Bilirubin and ALT were abnormally elevated, which prompted a hepatitis panel. Results follow:
HBsAg: -
Anti-HAV IgM: +
Anti-HBc IgM: -
Anti-HCV: -
The Dx is…………….
Hepatitis A
Name two routes of HAV transmission
Close person to person contact; ingestion of contaminated food or water
Which of the following describe the most common clinical symptoms and clinical course associated with HAV?
A. Jaundice always occurs
B. Onset is usually abrupt
C. Most cases involving children under age 6 are asymptomatic (70%)
D. Pts are potentially infectious for up to several weeks before the onset of symptoms
E. B and C
F. B, C, and D
G. All of the above
F
A 20 y.o. female is in the office and has been experiencing symptoms of fatigue, loss of appetite, nausea, vomiting, and abdominal pain. She has recently become sexually active with a new boyfriend. HIV and pregnancy tests are negative. Bilirubin and liver enzymes are elevated. Hepatitis panel results are:
HBsAg: +
Anti-HBc IgM: +
Anti-HAV IgM: -
Anti-HCV: -
Dx is?
Acute HBV
A surgical tech is accidentally stuck with a needle while working on a ‘high risk’ patient. What labs should be drawn from the patient?
HBsAg, HCV, HIV
A healthcare worker has just been stuck with a needle from a pt who previously tested positive for HBV. The HCW has never been vaccinated for HBV (She was scared of ‘preservatives’ in the vaccine and signed the decline form). What is the recommended post-exposure prophylaxis in this pt?
If pt is HBsAg positive: HBIG x1 and initiate Hep B vaccine series
If pt is HBsAg negatie: initiate Hep B vaccine series
A nurse walks in to your ER room after just getting stuck with a needle from a pt. who is HCV+. According to CDC guidelines, what labs should you draw?
Baseline testing for anti-HCV, HCV RNA, and alanine aminotransferase (ALT)
The nurse who had a needle-stick from an HCV+ pt is now in your office one month after exposure. What labs do you want?
Follow-up testing for HCV RNA between four and six weeks after exposure (CDC guidelines)
The nurse who had a needle-stick from an HCV+ pt is now in your office four months after exposure. What labs do you want?
Follow-up testing for anti-HCV, HCV RNA, and ALT between four and six months after exposure (CDC guidelines)
A PA walks into the ER having just been stuck by a needle from an HCV+ patient. What is the post-exposure prophylaxis protocol for Hep C?
Currently, there is no proven effective postexposure prophylaxis for persons exposed to HCV blood or contaminated body fluids. Immunoglobulin (Ig) and antiviral agents are not recommended for postexposure prophylaxis of HCV. Postexposure prophylactic use of interferon has not been demonstrated to reduce the rate of infection and interferon is associated with many side effects
The HBV vaccine series is the recommended protocol for pre exposure prophylaxis of Hep B. What is the pre exposure prophylaxis protocol for Hep C?
There is none.
What is the primary observed serious adverse effect of ribavirin?
Hemolytic anemia
