Hepatitis

Question 1

Viral hepatitis

Answer 1

systemic condition; mostly liver inflammation

Question 2

Viral causes of hepatitis

Answer 2

CMV, Epstein-Barr

Question 3

non-infectious causes of hepatitis

Answer 3

Drugs, chemicals, bacteria

Question 4

Most common types of hepatitis

Answer 4

HBV, HCV

Question 5

What type of hepatitis is the worst for pregnancy?

Answer 5

HEV

Question 6

Strains of hepatitis

Answer 6

HAV, HBV, HCV, HDV, HEV

Question 7

Patho of viral hepatitis

Answer 7

• Infection
• immune response (inflam mediators)
• lysis of infected cells
• edema and swelling around infectious cells
• tissue hypoxia
• hepatocyte death

Question 8

CM of viral hepatitis

Answer 8

Mostly asymptomatic; inc LFTs

Question 9

Stages of viral (A, B, and C) hepatitis

Answer 9

Prodromal, icteric, recovery

Question 10

Prodromal stage

Answer 10

• 2W post-exposure
• fatigue, anorexia, malaise, N/V, HA, hyperalgesia, cough, low fever
• highly transmissible

Question 11

Icteric “active phase”

Answer 11

• begin with jaundice
• 1-2 W post-prodromal to 2-6W
• jaundice, dark pee, clay poo
• liver enlarge and painful
• fatigue, ab pain peristent or inc in severity
• can become chronic from this stage

Question 12

Recovery phase

Answer 12

• enzymes back to normal 6-8W post-exp
• jaundice resolves
• liver remains longer and tender

Question 13

Complications of viral hepatitis

Answer 13

Chronic hepatitis, liver cirrhosis, liver cancer, fulminant viral hepatitis

Question 14

Hep A

Answer 14

• transmit via focal, oral, sexual, parenteral
• acute onset with fever
• usually mild
• doesn’t lead to chronic
• kids and adults
• hand hygiene, hep A vax

Question 15

Hep B

Answer 15

• transmit thru IDU or sex (often thru sub abuse communities)
• insidious
• severe, prolonged, or chronic
• any age affected
• HBV vax, safe sex, hygiene

Question 16

Hep C

Answer 16

• trans thru sex, IDU, maternal-fetal, medical mishaps
• slow, insidious
• more symptoms than B (mild to severe)
• 80% becomes chronic
• all ages affected
• screening, hygiene, NO vax

Question 17

What can Hep C lead to

Answer 17

hepatocellular carcinoma, liver transplant

Question 18

Hep A vax

Answer 18

• 2 doses 6M apart
• recommended for high risk (travel, HC, handling food)
• all kids begin at age 12M

Question 19

Hep B vax

Answer 19

• 3 doses 4M apart
• recommended for all infants
• titer for healthcare workers

Question 20

Hep C vax

Answer 20

THERE IS NONE

Question 21

HBV pharm

Answer 21

• quick medical advances
• often ppl get tx in clinic
• multiple strains, multiple drugs (mutates)

Question 22

Which hepatitis were you guaranteed to get if you were exposed to it in the 80s?

Answer 22

Hepatitis C

Question 23

Drugs for HBV

Answer 23

• interferons
• nucleoside analogs

Question 24

High risk for HBV

Answer 24

inc AST, hepatic inflammation, advanced fibrosis

Question 25

Disadvantages of HBV tx

Answer 25

long therapy, expensive, lots of SE, high relapse into acute hep

Question 26

HCV pharm

Answer 26

Now treated with new drugs for people with a detectable viral load
- for chronic disease
- direct-acting anti-viral therapy
- interferon based regiment
- nucleoside analogs

Question 27

How much Tylenol can people with hepatitis take?

Answer 27

2g but NOT if serious advanced liver disease (and no NSAIDs)

Question 28

Barrier to HCV pharm

Answer 28

$$$