Hepatitis Flashcards
How are Hepatitis A & E transmitted?
Fecal-Oral route (the vowels are in the bowls)
How are hepatitis B, C, and D transmitted? What are their most common modes of transmission?
Body fluids
B-Sex
C-IV drug use
D-from hep B (same mode)
Which hepatitis strand(s) have a vaccine? When are they given?
A & B
A: 2 doses, 6 months apart, part of the pediatric immunizations
B:3-4 doses over 6-18 months, peds immunization schedule and high risk groups (healthcare workers)
Which strands of hepatitis are acute? Which can turn chronic?
Acute: A&E
Can turn: B, *C, D
*rate of chronic illness is high
Which strands require supportive treatment? Which require medication?
A & E require only supportive treatment
B, C, and D require antiviral medications (Pegasus/interferon)
What does a positive IgM mean?
An active hepatitis infection
What does a positive IgG mean?
The patient has been vaccinated for Hep or has had a Hep infection and is immune to it
What is the post exposure protocol for Hep?
A: Immune globin (IG)within 2 weeks of exposure
B: IG within 24 hours of exposure (12 after birth if transmitted via child birth)
C: NONE
D: NONE
E: NONE
What other viruses can cause hepatitis/hepatitis like s/s? (Attack the liver)
Epstein Barr
Herpes simplex
Varicella Zoster
Cytomegalovirus
What are some hallmark s/s of hepatitis?
Jaundice/Icterus (dark urine, clay stools)
N/V/D, constipation, loss of appetite, ABD pain (Upper R Quadrant)
Fever, malaise, lethargy
Arthralgia, myalgia
Pruritus (itching)
When is a patient with hepatitis contagious?
Can be for up to 2 weeks BFORE s/s and 1-3 weeks AFTER s/s
What does a positive HBsAg mean?
Patient has a current Hep B infection
What does a positive Anti-HBs mean?
Patient has recovered from Hep B and is immune or is immune due to immunization
What is a normal ALT level? Will it elevate or decrease when infection is present?
7-56, elevate
What is a normal AST? Will it elevate or decrease when infection is present?
10-40, elevate
What is a normal bilirubin level?
<1
What is a normal ammonia level? Will it increase or decrease with infection?
15-45, increase
What is the most common indication of ammonia toxicity?
Mental status changes, confusion
What does lactulose do?
Decreases ammonia by flushing from the GI via diarrhea
What are the phases of hepatitis?
Preicteric/prodromal: body s/s (joint pain, fatigue, and pain, billi/AST/ALT elevated if tested)
Icteric: decreased body s/s, jaundice, enlarged liver and pain
Posticteric/convalescent: jaundice resolves, liver enzymes/billi decrease
