Hepatitis Flashcards

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1
Q

Hepatitis

A

-inflm of the liver

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2
Q

Hepatitis etiology

A
  • microbes -especially viruses
  • hepatotoxic durgs
  • autoimmunity (some types are d/t autoimmunity)
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3
Q

Viral hepatitis are the hepatitis________

A

-hep A, B, C, D, E (virus and infection have same
name)
-differences between these are: -virus & transmission
-incubation period
-severity
-mnfts are similar

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4
Q

Hep A

A
  • mild and acute
  • self-limiting (cannot ignore pt, but heals by self)
  • oral-fecal transmission
  • HAV, antiboides hep A virus antibodies Abs measured used to make a diagnosis)
  • no chronic or carrier stage
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5
Q

with Hep A person will have what kind of antibodies and they will be measured for?

A

Hep A virus antibodies and they will be measured to make a diagnosis

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6
Q

Hep B

A
  • more severe than Hep A
  • acute or chronic (10-15%)
  • carrier state (harbours virus, doesnt mnfts, can pass it on)
  • cirrhosis: end stage liver disease, not very common with hep B may develop
  • 3 Abs: anti-HBS (antigen that forms against this sits on the surface of the virus) anti-HBC (antigen that sits at core of virus) anti-HBe(referring to antigen in core & around core)
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7
Q

how is Hep A transmitted

A

-oral-fecal transmission

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8
Q

how is Hep B transmitted

A

-blood, most body fluids, oral, sexual

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9
Q

what are the three antibodies with Hep B

A

anti-HBs (antigen that forms against this sits on the surface of virus)
anti-HBc (antigen that sits at the core of the virus)
anti-HBe (referring to antigen in core and around core)

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10
Q

Hep C

A
  • chronic (80%)- cirrhosis & hepatocellular cancer
  • from infected blood
  • infected drug use (most common)
  • high risk sex practices (2nd)
  • Ab & viral tests for diagnosis (antibodies don’t serve as protective only serve for diagnostics)
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11
Q

patho of hepatitis

A

(similar in all types except auto immune)

  • 2 mechanisms in all types:
  • Viral injury causing necrosis
  • IR (normal immune response mediated injury) causing Inflm & necrosis
  • these lead to inflammatory damage and hepatocyte necrosis causing decreased liver function
  • liver is richly vascularized undergoing inflm damage d/t Immune res
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12
Q

Mnfts

A
3 phases 
Prodromal:
-lethargy, myalgia
-anorexia, nausea & vomiting 
-fever, abdm pain (liver has capsule that it is in, inflm causes swelling which stretches capsule which causes pain)

Clinical: (5-10 days later)

  • mnfts worsen
  • enlarged & tender liver
  • jaundice (bilirubin, cells that breakdown heme into bilirubin being damaged)
  • pruitits (d/t bile salts, accumulate & deposit in skin cause irritation)

Recovery:

  • acute mnfts subside (aprox 3 wks)
  • full recovery in approx 16 wk
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13
Q

what are the 3 phases for the manifestations of hepatitis

A
  • prodromal
  • clinical
  • recovery
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14
Q

Diagnosing hepatitis

A
  • history, physical exam

- measure liver enzymes (ALT & AST)-damaged release enzymes

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15
Q

why will hepatitis cause abdominal pain

A

-liver in a capsule, inflammation of liver causes swelling which stretches the capsule and causes pain

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16
Q

Treatment of hepatitis

A

(facilitate self-limitness)

  • bed rest (decrease energy requirement of the body)
  • smaller meals, increased calories and low fat (hepatic workload decreases)
  • no alcohol or hepatoxic drugs
  • symptomatic management
  • vaccines for Hep A & B (prevent) dont want to give vaccines to infected person
  • new direct acting antivirals (DAA) for Hep C only!: target specific stages in life cycel of virus-up to 95% cure rate
  • interferon can be used was used in the past: problems with side effects
17
Q

what are the 2 mechanisms that happen in hepatitis that would happen in any viral infection

A
  • Viral injury-causing necrosis: an aspect of viral infection is always cell damage by virus invading host cell & causing lysis (direct hepatocyte injury by virus)
  • IR (normal immune response mediated injury) causing Inflm & necrosis
18
Q

the liver has enormous _______ so that means

A

functional reserve that means alot has to happen before it shows it is failing

19
Q

autoimmune hepatitis is a ________ form

A

severe, chronic form (no recovery)

20
Q

Etiology of autoimmune hepatitis

A
  • complex trait: -genetic component + environmental component (usually triggered by bacteria or viral infection)
  • Idiopathic (because unclear of viral trigger or chemical trigger and what it will produce
  • HLA gene on chr 6 (proteins on cells that allow to differentiate self from foreign)
  • viral and chemical triggers
21
Q

what do the HLA genes on Chr 6 do?

A

proteins on cells that allow to differentiate self from foreign

22
Q

Type 1 autoimmune hepatitis

A
  • more common
  • 80% in females (about 1/3 are under 40-1/3 of that 1/3 have an autoimmune disorder already)
  • ANAs (antinuclear antibodies) & anti-smooth muscle abs
23
Q

in autoimmunity it is generally

A

antibodies and t cells damaging self

24
Q

what are the two antibodies with Type 1 autoimmune hepatitis

A

-ANAs (antinuclear antibodies) & anti-smooth muscle abs