hepatitis Flashcards

1
Q

Which organ should you think of if a patient complains of arthralgia or myalgias?

A

Think about the liver

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2
Q

What symptoms can a patient present with if they have acute viral hepatitis?

A

General: fatigue, fever, arthralgia, myalgia
Skin: rash, pruritis
HEENT: jaundice
GI: abdominal pain, anorexia, nausea/vomiting

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3
Q

What areas should you focus on with physical exam of someone with acute viral hepatitis?

A
Vital signs
Skin
HEENT
Cardiac, respiratory systems
Abdomen
Neuro
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4
Q

Which lab is most sensitive and specific marker for viral liver infections

A

ALT

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5
Q
ALT or AST differentials?
Fatty liver
Alcoholic liver
Drug/chemical toxicity
Hemachromatosis
A

ALT

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6
Q
ALT or AST differentials?
MI
Acute pancreatitis
Musculoskeletal trauma
Acute hemolytic anemia
Severe burns
A

AST

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7
Q

AST two times ALT

A

Alcoholic hepatitis
alcoholic cirrhosis
liver congestion
liver metastases

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8
Q

Enzyme in cells lining liver, biliary tract, bone
Differentials
Vitamin D deficiency
Metastatic/neoplastic disease
Cholestasis
Infiltrative liver disease (tumors, abscesses)
Granuloma

A

Alkaline Phosphatase

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9
Q

What do you look at to determine the source for the elevated alkaline phosphatase?

A

Look at isoenzymes to differentiate between bone or liver

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10
Q

Which do you look at (direct or indirect) bilirubin when assessing for viral hepatitis?

A
Direct (conjugated)
***Also present with Hepatic dysfunction
Obstruction of bile flow
possibly stones
tumor
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11
Q

Found in liver, heart, kidney, muscle
Source differentiated through isoenzymes
Differentials: MI, hemolytic anemias, tumors

A

Lactic Dehydrogenase (LDH)

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12
Q
LFTs 
AST: prejaundice increase up to several thousand units; not prognostic
ALT: later increase up to several thousand units; not prognostic
ALP, LDH: elevated; specifics require isoenzymes
Bilirubin: increased D/T
CBC: Low total WBC, leukopenia 
Differentials 
Low polys, bands: bandemia
High lymphs: lymphocytosis
H/H: mild anemia
Albumin: +/-
Prothrombin time: +/-
A

Acute Viral Hepatitis Lab Results

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13
Q

What could a prolonged prothrombin time (PT) indicate in a patient with acute viral hepatitis?

A

Prolonged duration indicates impending liver failure; need to test for specific viral markers

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14
Q

acts as primary, long-term antibody against viruses/bacteria, fixes complement

A

IgG

think G for GONE as in the acute infection is gone.

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