hepatitis Flashcards
Hepatitis-Inflammation of the liver causes?
causes a chemical drug reaction to drugs, alcohol and other toxins
Hepatitis A Virus (HAV)
Ranges from mild to acute liver failure, not chronic
Incidence decreased with vaccination
RNA virus transmitted via fecal-oral route
Contaminated food or drinking water
Hepatitis B Virus (HBV)
Acute or chronic disease
Incidence decreased with vaccination
DNA virus transmitted
Perinatally, percutaneously and via mucosal exposure to infectious blood, blood products, or other body fluids
Hepatitis C Virus (HBCV) can be?
Acute: asymptomatic, chronic: liver damage
virus transmitted percutaneously
IV drug use, high-risk sexual behaviors, occupational exposure, dialysis, perinatal exposure, blood transfusions pre-1992
Hepatitis D Virus (HDV) - Delta virus
Cannot survive on its own, requires hepatitis B to replicate
Transmitted percutaneously
No vaccine
How Hepatitis E Virus (HEV) transmitted?
Transmitted via fecal-oral route. Most common mode of transmission: drinking contaminated water
Occurs primarily in developing countries
Signs & Symptoms of viral hepatitis
Many patients: asymptomatic
Symptoms intermittent or ongoing
Acute phase
Maximal infectivity; lasts 1–4 months
Symptoms during incubation: Malaise Anorexia Weight loss Fatigue Nausea/vomiting Abdominal discomfort Distaste for cigarettes ↓ Sense of smell Headache Low-grade fever Arthralgias Skin rashes
Pathophysiology
Acute infection;
Liver damage: lysis of infected cells
Cholestasis
Liver cells can regenerate after resolution of infection
Chronic infection can cause fibrosis and progress to cirrhosis
Antigen-antibody complexes activate complement system manifested as;
Rash, Angioedema, Arthritis, Fever, Malaise, Cryoglobulinaemia, Glomerulonephritis, Vasculitis
Acute phase-hepatitis
Signs & Symptoms
Physical examination findings;
Hepatomegaly - enlargement of the liver
Lymphadenopathy - disease of the lymphnodes
Splenomegaly - enlargeed spleen
Icteric (jaundice) or anicteric
If icteric, patient can also have;
Dark urine
Light or clay-colored stools
Pruritus
Convalescent phase-hepatitis
Signs & Symptoms
Begins as jaundice is disappearing;
Lasts weeks to months
Major complaints: Malaise and easy fatigability
Hepatomegaly persists, Splenomegaly subsides
Recovery;
Homologous immunity to HAV or HBV.
Patient can be reinfected with other types of viral hepatitis, as well as different strains of HCV.
Most patients recover completely with no complications
Complications
Acute liver failure
Chronic hepatitis
Some HBV and majority of HCV infections
Cirrhosis
Hepatocellular carcinoma
Treatment - acute and chronic
Well-balanced diet, vitamin supplements
Rest: degree varies with severity
Avoid alcohol intake and drugs detoxified by the liver
Notification of possible contacts
Treatment - drug
Acute hepatitis A: no specific
Acute hepatitis B: only if severe
Acute hepatitis C: Pegylated interferon
Support therapy: antiemetics
