Hepatitis (Online Lecture) Flashcards
liver is located where
RUQ
liver has how many lobes
2
liver receives blood from the
hepatic artery in the hepatic portal vein
the liver is a very _____________ organ
vascular
bile is synthesized in the liver and transported to
ducts
3 main function categories
- storage
- production
- metabolism
example of storage function of liver
glycogen storage
vitamin storage
example of production function of the liver
clotting factors
produces bile
example of metabolism function of the liver
converts CHO to triglycerides
degradation of lipids
protein synthesis, metabolism and transport
hepatotoxins
alcohol and drug use, including Tylenol
why would we want to inspect the skin
jaundice
where should we check for jaundice in patients with darker skin tones
sclera
what might we find during our abdominal assessment
ascites
ascites can lead to issues of what other systems
respiratory issues
why do we see ascites and edema is patients with liver issues
lacking of production of albumin
albumin does what
make fluid stay in the vessel
why might liver biopsy be difficult
higher risk for bleeding
why are patients with liver issues at higher risk for bleeding
liver makes clotting factors
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)
what are some other tests we might want to run to assess liver function
CBC (bleeding
platelet
hemoglobin
what are some diagnosis tests we can do
ultrasound
CT
MRI
Laparoscopy
benefits of ultrasounds
low cost
low risk
fast
what do we need to assess for before CT
allergies
kidney function (BUN and CR)
what do we need to assess before MRI
implanted devices
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
more
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
no
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