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Pathophysiology Term 2 > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

What is hepatitis?

A

a complex disease that involves inflammation of the liver

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2
Q

What causes hepatitis?

A
  • microbes (parasites, viruses, bacteria, fungi), especially viruses
  • drugs (hepatotoxic drugs - whether prescription, OTC, illicit)
  • autoimmune (low incidence)
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3
Q

What causes hepatitis A, B and C?

A

Hepatitis A, B and C viruses.

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4
Q

How is hepatitis A spread?

A

oral-fecal route

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5
Q

How is hepatitis B spread?

A

saliva, sex, serum/blood products

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6
Q

How is hepatitis C spread?

A

blood and blood products, possible to be spread through sex

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7
Q

What is the incubation period for hepatitis A?

A

15-50 days

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8
Q

What is the incubation period for hepatitis B?

A

28-160 days

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9
Q

What is the incubation period for hepatitis C?

A

15-160 days

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10
Q

Which forms of hepatitis can have carrier states?

A
  • no carrier state for hepatitis A
  • sometimes carrier state for hepatitis B
  • often carrier state for hepatitis C
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11
Q

Which forms of hepatitis are chronic?

A
  • hepatitis A is usually acute, not chronic
  • a small percentage of hepatitis B is chronic (10-15%)
  • hepatitis C is most often chronic (80% of cases), with a pattern of exacerbation and remissions
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12
Q

What problem often results from hepatitis C?

A

cirrhosis

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13
Q

What are the two mechanisms of injury that occur in hepatitis?

A

1) immune response causes inflammation and necrosis (this damages hepatocytes as well as blood vessels and ducts)
2) viral injury - the virus targets hepatocytes and causes them to lyse, decreasing liver function

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14
Q

What lab tests would be abnormal in someone suffering hepatitis?

A

ALT and AST are liver enzymes that escape into the blood when hepatocytes are damaged. These will be elevated in a person suffering hepatitis.

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15
Q

How long does it take the liver to heal after it has been damaged by hepatitis virus?

A

Around 4 months

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16
Q

The symptoms of viral hepatitis are split into three phases - what are they?

A

1) prodromal stage
2) clinical stage (5-10 days after the prodromal stage)
3) recovery stage

17
Q

What are the symptoms of viral hepatitis that occur during the prodromal stage?

A
  • lack of energy, lethargy, myalgia
  • fever
  • abdominal pain (due to hepatomegaly, the inflamed liver stretches the liver capsule causing pain)
  • anorexia, nausea and vomiting
18
Q

What manifestations occur during the clinical stage of viral hepatitis?

A
  • previous manifestations worsen (lethargy, fever, abdominal pain, anorexia, nausea and vomiting)
  • jaundice (from accumulation of bilirubin since liver breaks down bilirubin further to make bile)
  • pruritis (from deposition of bile salts in the skin)
19
Q

What occurs during the recovery stage of viral hepatitis?

A
  • acute manifestations subside in the first few weeks

- complete recovery needs 4 months/16 weeks (time required to regenerate hepatocytes)

20
Q

How is hepatitis treated?

A

minimize liver workload to allow hepatocytes ability to regenerate:

  • rest (decrease energy requirement)
  • change diet (small meals high in calories, limit fat content so liver doesn’t have to make so much bile)
  • NO alcohol or other hepatotoxic drugs
  • relieve symptoms (ex. pruritis)
  • post exposure prophylaxis (PPE, increase hygiene to prevent spread, for Hep A & B can give antibodies or vaccine, for Hep C give antiviral drugs)
21
Q

What is autoimmune hepatitis?

A

a severe, chronic form of hepatitis

22
Q

What causes autoimmune hepatitis?

A

complex trait:

  • involves HLA genes on chromosome 6 as well as other genes
  • involves an environmental trigger (viruses, chemical agents)
23
Q

What is type 1 autoimmune hepatitis? What antibodies are involved?

A
  • more common form
  • 30% of cases are females under 40 yrs
  • the antibodies inflict damage to the liver: antinuclear antibodies (ANAs) target all cells with DNA, RNA, and anti-smooth muscle antibodies target the smooth muscle in blood vessels and ducts in the liver
24
Q

What is type 2 autoimmune hepatitis? What antibodies are involved?

A
  • most often affects kids 2-14 yrs old
  • 2 different antibodies:
    1) antibodies against cytosol
    2) antibodies against microsomes
25
Q

How does autoimmune hepatitis manifest?

A

can range from asymptomatic to liver failure

26
Q

How is autoimmune hepatitis diagnosed?

A
  • exclude viral hepatitis, chronic liver disease or acute liver disease
  • look for elevated levels of antibodies
27
Q

How is autoimmune hepatitis treated?

A
  • immuno-suppressant drugs

- liver transplant if unresponsive to drugs

28
Q

What is a complication of autoimmune hepatitis?

A

cirrhosis

Pathophysiology Term 2 (65 decks)

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