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Human Diseases > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

Implications of hepatitis?

A

Cross-infection
Bleeding
Anaesthesia/drugs

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2
Q

Causes of hepatitis?

A

Viral - Hep A B C, Epstein Barr virus (glandular fever)
Drug reactions - paracetamol (acute liver damage)
Uncommon - autoimmune
Rare - Wilson’s disuse (liver problem), toxins

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3
Q

What is acute hepatitis?

A

Self limiting liver inflammation

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4
Q

What causes acute hepatitis?

A

Viral, acute alcoholic hepatitis, drugs, toxins, medication

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5
Q

Investigations for acute hepatitis?

A

LFTs - liver function tests - test hepatic enzymes
tests to determine cause e.g. viral serology, immunoglobulins, autoantibody profile
Live ultrasonology

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6
Q

Clinical features of chronic liver disease?

A

Cirrhosis

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7
Q

Causes of chronic liver disease?

A

Chronic Hep C and alcohol abuse

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8
Q

Signs and symptoms of chronic liver disease due to…?

A

Liver fibrosis
Reduced liver cell mass
Portal hypertension

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9
Q

What is the effect of reduced liver cell mass?

A

Liver does not detoxify as well = encephalopathy = reduced attention span, reverse sleeping pattern

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10
Q

What are the signs and symptoms of chronic liver disease?

A

Encepahlopathy due to reduced liver cell mass
Loss of lean body mass
Accumulation of body water
Coagulopathy

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11
Q

Why does chronic liver disease cause accumulation of body water?

A

Effect on protein metabolism, fluid leaks out into extravascular spaces, due to change in oncotic pressure

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12
Q

What will patients with chronic liver disease often present with in history?

A 
Jaundice 
alcohol intake
Known infections
History of drug intolerance
Bleeding disorder
IV drug use
Sexual history
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13
Q

Suggest some Q that can establish whether a patient in in high risk category for infection of blood borne virus?

A

Have you ever been told you are positive for HIV/AIDS or Hep B/C?
Have you ever injected yourself with drugs? This includes body building drugs?
have you ever received a blood transfusion outside of UK? if yes where?

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14
Q

Signs of jaundice?

A

Yellow skin - especially in the eyes

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15
Q

What is sider nevi?

A

Central artery with small arterioles coming out

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16
Q

What will patients with chronic liver disease present with in examination?

A 
Jaundice
Brusing
Spider naevi
Liver flap (asterixis)
scratch marks 
Sialosis (enlargement of salivary glands) 
Palmar Erythema (red palms)
17
Q

What do raised levels of alanine transaminase (ALT) and aspartate transaminase (AST) suggest?

A

Problem with liver cell integrity (due to excess alcohol or infection)

18
Q

It what kind of patient will gammons glutamyl transpeptidase be raised?

A

Alcoholics

19
Q

What liver function test can distinguish between alcohol induced liver damage and infection?

A

ALT and AST raised in both

gamma GT only raised in alcoholics

20
Q

How will alkaline phosphatase change in liver problems?

A

Raised

21
Q

How to reduce cross infection of infectious disease?

A

Immunisation
Hand washing
Avoidance of needlestick
masks, gloves, specs

22
Q

Explain the serological markers for Hep B

a) hep B surface antigen
b) Anti Heb B surface antigen
c) hep B core antigen
d) Hep B e Antigen

A

a) marker of ongoing infectivity
b) protection from infection
c) donor infectivity
d) only found if His Ag positive - signifies active viral replication - index of infectivity

23
Q

Where are drugs metabolised?

A

Liver

24
Q

What is hepato-renal syndrome?

A

Kidney failure due to liver failure

25
Q

why are patients with jaundice given the least toxic anaesthetics?

A

Higher risk of leading to hepato-renal syndrome

26
Q

In patients with liver problems, should you prescribe miconazole and fluconazole?

A

Miconazole is contra-indicated. Fluconazole should be at a decreased dose

27
Q

Why should NSAIDS be avoided in patients with liver problems?

A

GI bleeding

28
Q

What are alcoholics at risk of in terms of problems with liver?

A

Haematemesis (vomiting blood) due to portal hypertension

29
Q

Due to the risk of haemeatemesis in alcoholic patients, they often take beta blockers, why is this of importance when prescribing anaesthesia?

A

Reduced plasma clearance of epinephrine (adrenaline)

30
Q

What are the risks in terms of bleeding in alcoholic patients?

A

Increased bleeding

31
Q

What 3 things should you think about if treating a patient with hep/liver problems?

A

Cross-infection
Bleeding
Issues relating to anaesthesia/drugs

Human Diseases (37 decks)

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