hepatitis Flashcards
travelers diarrhea medication
floxacins (norlofxacin not recommended)
azithromycin (can send them with rx)
rifaxamin
sx hepatitis
malaise n/v/abd pain ha muscle joint pain rash itching
hepatitis objective findings
jaundice fever hepatosplenomegaly tender liver rash elevetated LFT dark urine clay colored stool lymphocytosis
hep A transmission
risks
chronic infx?
oral-fecal
risks: contaminated food-water, travel
MSM, drug abuse
no chronic infx
hep A incubation
shedding ___ wks prior and ___ wk after sx
how long do sx last?
presentation?
28 d
2 weeks prior and 1 week after sx
2 weeks- several months
present with viral GI then jaundice
hep A lab test
anti-HAV with igm during acute
hep A immunity after infx?
most recover and will be immune
prevention of hep A
prexposure:
postexposure:
other:
preexposure: vaccine (2 doses)
post: vaccine and/or immune globulin within 2 weeks of exposure
other: good hygiene clea water
preexposure vaccination with hep A
40 or immunocompromised
40 or comorbidities- 2 weeks before or vaccine + immune globulin
hep B transmission
risks
bloodborne percutaneous permucosal sexually transmitted
risks: sex, IVDA, maternal-child, health care
hep b incubation how long does it last? 30-50% are \_\_\_\_\_\_\_\_ chronic infx= risk factor for\_\_\_\_\_\_\_ PEP:
90 days 4-6 weeks acute 30-50% are asymptomatic chronic infx= risk factor for carcinoma PEP: within 24 hours of exposure
hep B serology
HBsAG=
HBsAB=
anti-HCB AKA _____=
HBsAG= person infected
HBsAB= immune (immunized or disease)
anti-HCB AKA HBcAb= positive infection past or present
HBsAG -
HBsAB +
HbcAb/anti-HCB -
HBsAg-
HBsAb +
HbcAb/anti-HCB +
not infected
immune
no current or past infection, got vaccinated
not infected
immune
previously infected
HBeAg is associated with
HBeAb is associated with
high infectivity, bad prognosis
lower infectivity, shows up early then lower infectivity
Hep B vaccination
ages
testing
through 18 or 18+ and high risk (HCW, hemodialysis, multiple sex partners, correctional, MSM, IVDU)
pre- not recommended
post- 1-2 months after for HCW
Hep B tx
refer to GI
acute: supportive
chronic: dont memorize meds
Hep C transmission
risks:
chronic?
bloodborne, percutaneous, permucosal
risks: IVDA, blood product before July 1992, clotting before 1987, birth mother
chronic 75-85%
hep c incubation
most do not present with _____
major cause of ______
risk factor for_____
4-12 weeks
most do not present with acute illness
major cause of liver failure
risk factor for hepatocellular carcinoma
Hep C prevention there is no\_\_\_\_ -drugs? -sharing? - HCW: - sexual?
there is no vaccine IVDA: stop, clean do not share razors, toothbrush hcw: sharps, universal precautions sexual transmission rare, condoms
Hep C serology
anti-HCV then HCV RNA if positive
Treatment hep C dx: referral: nonpharmacologic: pharmacologic:
liver biopsy genotype
refer to GI
no ETOH, immunization against hepatitis
pharm: sovaldi, olysio (80-95%) pegylated interferon/ribivirin (40-80%)
Factors that increase progression of hepatitis C - - - -
- ETOH
- > 40
- HIV or Hep B
- male
Hepatitis C testing - - - -
- 1945-1965
- IV drug users
- medical conditions (clotting before 1987, chronic hemodialysis, liver disease)
- transfusion/organs (before 1992)
Hepatitis D transmission risks vaccine chronic
bloodborne
hepatitis B (need B to have D)
no vaccine
yes chronic infection
Hepatitis E transmission risk vaccine chronic
oral-fecal (similar to A)
developing world
no vaccine
no chronic infection
Liver function tests AST: also found in ALT Alk phos Bili
AST: statin/scotch- rises fast, clears quickly, also found in heart/muscle/brain/kidneys
ALT: hepatitis/liver, specific, persists
alk phos: gallbladder
Billi: elevated in hepatitis, jaundice + 2.5
