Hepatitis Flashcards
Which types of Hep can be come chronic?
B, C, D
Hepatitis that is only acute
A and E
Fulminant Hepatitis means…
Acute Liver failure in the setting of Hepatitis
Encephalopathy, Coagulopathy, Hepatomegaly, Jaundice, edema, ascites, asterixis, hyperreflexia
AST and ALT values of Acute and Chronic Hep
Acute: >500
Chronic: <500
What can cause Fulminant Hepatitis? (Acute liver failure)
Acetaminophen toxicity (tylenol)
Viral hep
Reye syndrome- kids given ASA after viral infection
Reye syndrome
when you give ASA to a child after viral infection
Tx of Fulminant Hepatitis
IVF
Mannitol (if ICP elevation)
Blood products of platelets
Definitive: liver transplant
Hep A- acute always
Fecal-oral, International travel
May be A-sx, or SPIKING FEVER
Tx: none, self limiting
Prevent: Sanitation and handwashing
If you’ve been exposed: HAV vaccine. If you are immunocomp or have chronic liver dz, get HAV and HAV immunoglobulin
Hep E is always acute, but what is the worry?
Highest mortality due to Fulminant Hep during pregnancy
(esp during 3rd trimester)
Transmission: mother to child, fecal-oral, blood transfusion
What does Hep D need in order to be present?
Hep B!
Hep D details
Transmission: blood
Tx: none FDA approved, but can try Interferon alpha if chronic, and Liver transplant as definitive
Prevention: get the Hep B vaccine!
Hep C is known for
becoming CHRONIC "C for Chronic" Most common infectious cause of: -Chronic liver dz -Cirrhosis -Liver transplant
Transmission of Hep C is usually
IVDU
or needlestick injury
How long does it take for Hep C antibodies to become positive?
within 6 weeks
Is Hep C curable?
thankfully, YES
> 95% cure rate within 12 weeks of oral therapy
The type of Hep with all the crazy antibodies
Hep B
Tx for Hep B
Supportive is mainstay, most pts will not advance to Chronic
Tx for Chronic hep B
If pt has persistent or severe sx, marked jaundice, etc
Antiviral therapy: Entecavir, Tenofovir
Hep B vaccine
Infant: birth, 2 mo, 6-18 mo (3 doses)
Adult if not previously vaccinated: 0, 1, and 6 mo (3 doses)
How many doses of Hep B vaccine do you normally get?
3 doses
Contra to Hep B vaccine
Baker’s yeast
Remember the order of antibody initiation
“My Grandma…..”
M, then G
Hep B antibodies
if IgM= acute
if IgG= chronic
If the surface antigen is present,
either have positive Acute or Chronic Hep