Hepatitis Flashcards
What is hepatitis?
Severe liver inflm
3 possible causes of hepatitis:
- Microbes
- Hepatotoxic drugs
- Autoimmunity
What specific type of microbe is usually the cause of hepatitis?
Viral
What are the most common forms of hepatitis?
A, B, and C
Out of A, B, and C, which is the worst form of hepatitis?
C
The mnfts of the hepatitis’ are similar, but what aspects are different?
- Virus
- Transmission
- Incubation period
- Severity
- Carrier state
Describe hepatitis A
4
- Mild, acute form
- Mode of transmission: oral-fecal
- Lasts ~1 month
- Anti-HAV Abs
Describe hepatitis B:
5
- More severe
- ~10-15% chronic
- Mode of transmission: blood, bodily fluids, oral, sexual
- Carrier state
- Anti-HBs, anti-HBc, and anti-HBe Abs
Where are anti-HBs, anti-HBc, and anti-HBe Abs found?
HBs - On the surface of the virus
HBc - At the core of the virus
HBe - On the envelope of the virus
Describe hepatitis C:
- ~80% chronic
- Can be contracted via blood and blood products, IV
drugs, and high risk sexual practices - Carrier state
- Anti-HCV Abs
What is a another liver issue which may arise as a complication of hepatitis B?
Cirrhosis
What are 2 another liver issues which may arise as complications of hepatitis C?
- Cirrhosis
- Liver CA
What are the 2 mechanisms involved in hepatitis that result in cell necrosis?
- Viral injury -> cell necrosis
- The immune response causes inflm -> tissue damage
- > cell necrosis
What structures in the liver are damaged by hepatitis?
- Hepatocytes
- Vasculature
- Ducts
What is the role of the hepatocytes?
They are the functional cells of the liver
Approximately how long does it take to heal from hepatitis?
~4 months
What are the 3 phases of hepatitis?
- Prodromal
- Clinical
- Recovery
What mnfts accompany the prodromal stage of hepatitis?
6
- Lethargy
- Myalgia
- Fever
- Abdm pain
- Anorexia
- Nausea/vomiting
Is the nausea/vomiting in hepatitis a systemic or local mnft?
Local
What is myalgia?
Pain in a muscle or group of muscles
When does the clinical stage begin?
About 5-10 days after the prodromal stage
What mnfts accompany the clinical stage of hepatitis?
3
- Earlier mnfts worsen
- Hepatomegaly
- Jaundice
- Pruritus
What is the hepatomegaly in hepatitis due to?
Inflm and swelling
What is the pruritus in hepatitis due to?
The deposition of bile salts in the skin
How long does the recovery stage of hepatitis last?
Acute mnfts should subside in about 3 weeks, full recovery in 16 weeks
What is used as Dx tools for hepatitis?
- Serology (looking for mnfts)
- Viral testing
Which of the hepatitis’ is self limiting?
Hepatitis A
Why are pts with hepatitis put on bed rest?
To indirectly rest their liver
What is done to directly rest the liver when a pts has hepatitis?
- NO alcohol
- NO hepatotoxic drugs
T or F:
You can be vaccinated in order to avoid contracting any forms of hepatitis
F, you can be vaccinated from A and , but not from C
What Tx for hepatitis C has had a success rate of 95% of pts being cured?
A new direct acting antiviral (DAA)
Is autoimmune hepatitis a classic or non-classic form of autoimmunity?
Classic
T or F:
Autoimmune hepatitis is a mild, but chronic form of hepatitis
F, it is a severe and chronic form
In autoimmune hepatitis, there is a mutation on the HLA gene located on which chromosome?
6
What are 2 triggers for autoimmune hepatitis?
- Environmental triggers
2. Chemical triggers
Describe type 1 of autoimmune hepatitis:
- ~80% in women age 40 and under
- 1/3 have pre-existing autoimmune disorders
- AutoAbs
- Anti-nuclear Abs and anti-smooth muscle Abs
What is targeted by an anti-nuclear Ab?
Anything with a nucleus
What is targeted by an anti-smooth muscle Ab?
Smooth muscle
- eg in the blood vessels and ducts in the liver
(pro tip: if you replace “ducts” with “ducks”, and imagine a bunch of ducks running around the liver, these disorders are a lot more enjoyable)
T or F:
Type 2 of the autoimmune hepatitis is less common than type 1
T
What age group is generally affected by autoimmune hepatitis type 2?
2 - 14 year olds
What are the Abs in autoimmune hepatitis type 2 targeting?
Cytosol and microsomes
What is cytosol?
The aqueous component of the cytoplasm of a cell that the organelles and particles are suspended in
What are microsomes?
A fragment of endoplasmic reticulum and attached ribosomes obtained by the centrifugation of homogenized cells.
What are the mnfts of autoimmune hepatitis?
- Varying severity
- Asymptomatic to liver failure
What is the Tx for autoimmune hepatitis?
- Immunosuppressants
- Transplant ??