Hepatitis (Online Lecture) Flashcards by Lani Manners

liver is located where

RUQ

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liver has how many lobes

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liver receives blood from the

hepatic artery in the hepatic portal vein

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the liver is a very _____________ organ

vascular

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bile is synthesized in the liver and transported to

ducts

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3 main function categories

storage
production
metabolism

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example of storage function of liver

glycogen storage
vitamin storage

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example of production function of the liver

clotting factors
produces bile

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example of metabolism function of the liver

converts CHO to triglycerides
degradation of lipids
protein synthesis, metabolism and transport

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hepatotoxins

alcohol and drug use, including Tylenol

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why would we want to inspect the skin

jaundice

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where should we check for jaundice in patients with darker skin tones

sclera

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what might we find during our abdominal assessment

ascites

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ascites can lead to issues of what other systems

respiratory issues

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why do we see ascites and edema is patients with liver issues

lacking of production of albumin

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albumin does what

make fluid stay in the vessel

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why might liver biopsy be difficult

higher risk for bleeding

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why are patients with liver issues at higher risk for bleeding

liver makes clotting factors

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what are some liver function tests

direct and indirect bilirubin
serum protein and albumin
prothrombin time (clotting)
Alk phos (obstruction)
AT and ALT (liver cell damage)
serum ammonia (livers ability to filter ammonia)

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what are some other tests we might want to run to assess liver function

CBC (bleeding
platelet
hemoglobin

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what are some diagnosis tests we can do

ultrasound
CT
MRI
Laparoscopy

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benefits of ultrasounds

low cost
low risk
fast

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what do we need to assess for before CT

allergies
kidney function (BUN and CR)

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what do we need to assess before MRI

implanted devices

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laparoscopy is

exploratory

jaundice is the disruption of

bilirubin metabolism

what would the bilirubin number be in jaundice

>2.5

what can jaundice be caused by

hemolytic hepatocellular obstructive hereditary hyperbilrubinemia

hemolytic cause of jaundice

excessive breakdown

obstructive cause of jaundice

gallstone or tumor

esophageal varies are secondary to

portal hypertension

3 infections we care about

A, B, C

HEP A duration and posibility to become long term

short term doesn't become long term

HEP B duration and posibility to become long term

can also be short term but can become chronic

HEP C duration and posibility to become long term

can also be short term but can become chronic

vaccines are available for

A and B

Hep A is caused by what virus

RNA

Hep A causes what in the liver

acute inflammation

Hep A you can have passive immunity from

gamma globulin

Hep A contamination

fecal-oral

Hep A incubation period

2-6 weeks

Hep A since the incubation period is so long

you could be spreading it unknowingly

Hep A diagnosis, based on __________

symptoms

Hep A enlarged ________ and __________

liver, spleen

Hep A jaundice or not

yes

Hep A confirmation HAV antigen

in stool 7-10 days before s/s

Hep A conformation HAV antibodies

2-3 weeks after symptoms

Hep A is it self limiting

yes

Hep A contact

person to person not blood

Hep A how long do symptoms last

~8wks less than 2 months

Hep A recovery is longer in

older adults

Hep A most contagious

10-14 days before symptoms

Hep A low or high mortality

low

Hep A prevent spread

hand hygiene

Hep A signs and symptoms

fever fatigue loss of appetite N/V abdominal pain diarrhea and clay colorer bowel movements joint pain indigestion

Hep A later signs and symptoms

jaundice and dark urine

Hep A starts as

mild flu like or upper respiratory infections

Hep A more or less symptoms is older children and adults

Hep A strong aversion to

cigarette smoke/other strong odors

Hep A disease progression is

supportive

Hep A avoid

hepatotoxic - including acetaminophen

Hep A supportive care

bed rest nutrition IV fluids

Hep A prevention of transmission

meticulous hand washing proper sewage disposal vaccination

Hep A vaccination is recommended for higher risk patients

- traveling (high hep A area) - outbreaks - homosexual males - drug users - chronic liver disease - clotting factor disorders - close contact with someone with Hep A

Hep B virus

DNA

Hep B transmission

blood and body fluids (needles, semen, vaginal secretions, mucous or skin break, mom to baby, breast feeding)

Hep B incubation period

30-100 days

Hep B impacts livers ability to

function properly

Hep B high risk patient

homosexual males heterosexual with many partners IV drug users

Hep B vaccines for high risk

dialysis patients IV drug abusers sexual activity with out protection healthcare workers

Hep B moraality rate

low

Hep B diagnostics HBsAG

detectable 1-10 weeks after exposure carrier state if persists longer than 6 months

Hep B diagnostics anti HB

indicates immune state

Hep B chronic

~10% develop to chronic or carrier state

Hep B is the major cause for

cirrhosis and hepatocellular carcinoma

Hep B signs and symptoms

fever fatigue loss of appetite N/V abdominal pain dark urine grey stools

since Hep A and B signs and symptoms look so similar how do we differentiate

health history

Hep B prevention

blood donor screening needless IV systems

Hep B active immunity

vaccination

Hep B vaccination is recommended for

IV drug users healthcare workers dialysis STI infants travelrs Hep C chronic liver disease HIV incarcerated

Hep B passive immunity

immune globin

Hep B when would we use immune globulin

if exposed and not previously vaccinated

Hep B what do you do after immune globulin is abdministered

prompt vaccine increases likelihood of protection

Hep B management alpha interferon

decrease inflammation of liver reduces signs and symptoms IM injection side effects: fever, chills, general malaise

Hep B management antiviral agents is used for chronic or acute

chronic

Hep C virus

RNA

Hep C transmission

blood contact with skin/mucous membranes (sexual contact, piercing, tattoos)

Hep C vaccines

Hep C incubation

1 week to several months

Hep C symptoms are so similar so we rely on

blood tests

Hep C common among

IV drug users dialysis

Hep C development to chronic form

85%

Hep C leading cause of

liver cancer and cirrhosis

Hep C effective treatment

combo of antiviral agents

Hep C why do we use antiviral agents

preventing relapses and s/s

Hep C side effects of antiviral agents

fever maliase headache depression heart failure hypertension confusion

Hep C what type of precautions

universal

Hep C when we are symptom managing are we going to use Tylenol

no (check metabolism of drugs before use)

Hep C teaching

liver toxins carriers proper disposal cannot be blood donor