Hepatitis Flashcards
What is fulminant hepatitis?
A rare syndrome of massive necrosis of liver parenchyma and a decrease in liver size (acute yellow atrophy) that usually occurs after infection with certain hepatitis viruses
What is the difference between chronic + acute hep B (timings)?
Acute - 1-3 months
Chronic - >6 months
What is chronic hep b?
Persistence of serum HBsAg
Most people are inactive carriers, some develop chronic active hepatitis
Can cause cirrhosis + hepatocellular carcinoma
Management of pt with hep B
Bloods + liver US scan Pain relief + itch + nausea Tx Notify HPU Avoid alcohol, prevent transmission Antivirals
What is hep A?
Self limiting viral infection transmitted by fecal-oral route
What are the features of viral hepatitis (in phases)?
Prodromal phase = flu symptoms, GI symptoms, headache, cough, pharyngitis, constipation, itchy
Icteric phase = jaundice, pale stools + dark urine, pruritus, N+V, fatigue
Hepatomegaly, splenomegaly + lymphadenopathy
Convalescent phase = malaise + hepatic tenderness
How is hep A confirmed?
Acute illness AND jaundice or elevated AST/ ALT AND confirmed Igm Ab to hep A
Management of hep A
Symptomatic support
Notify HPU
What is hepatitis C?
Slow progressive disease caused by HCV
Ranges from asymptomatic to end stage liver failure + cancer
What is acute vs chronic hep C?
Acute = period immediately following incubation to 6 months - usually asymptomatic Chronic = >6 months
How many types of Hep C are there?
6
RF for getting hep C
Sharing drug equipment, receiving unscreened blood transfusion/ products, donor organs, unsterile tattoos/ piercings, needlestick injuries, vertical or sexual transmission
How many people clear the virus + how many develop chronic hep C?
25-50% clear it
50-80 develop chronic infection
When should hep C be tested for?
Clinical features of hepatitis
Abnormal LFTs
RF for hep C present
Management of hep C
Lifetyle advice - stop smoking + alcohol
Give hep A + B immunisation