Hepatitis A

Question 1

What is the typical history associated with hepatitis A?

Answer 1

Fever, fatigue, nausea, vomiting, abdominal pain. Dark urine, pale stools, jaundice. History of travel to endemic areas or consumption of contaminated food/water.

Question 2

What are the key physical examination findings in hepatitis A?

Answer 2

Jaundice, hepatomegaly. Tenderness in the right upper quadrant. Possible mild splenomegaly.

Question 3

What investigations are necessary for diagnosing hepatitis A?

Answer 3

Elevated liver enzymes (ALT, AST). Positive anti-HAV IgM antibodies. Elevated bilirubin levels.

Question 4

What are the non-pharmacological management strategies for hepatitis A?

Answer 4

Rest and hydration. Avoid alcohol and hepatotoxic drugs. Good personal hygiene and sanitation practices.

Question 5

What are the pharmacological management options for hepatitis A?

Answer 5

No specific antiviral treatment. Symptomatic treatment with antiemetics and analgesics (avoid acetaminophen). Consider prophylactic immune globulin for close contacts.

Question 6

What are the red flags to look for in hepatitis A patients?

Answer 6

Severe abdominal pain, persistent vomiting. Signs of acute liver failure: confusion, severe jaundice, bleeding tendencies. Signs of dehydration.

Question 7

When should a patient with hepatitis A be referred to a specialist?

Answer 7

Signs of acute liver failure. Severe or prolonged symptoms. Underlying liver disease or immunocompromised state. Pregnant women with severe symptoms.

Question 8

What is one key piece of pathophysiology related to hepatitis A?

Answer 8

Caused by hepatitis A virus (HAV), a picornavirus. Transmitted via the fecal-oral route. Virus replicates in hepatocytes, causing liver inflammation and jaundice.