Hepatits Flashcards by ashley Hassler

General symptoms of hepatitis

Loss of appetite
Fatigue
URQ pain
Jaundice
Clayish or whitish color stool
Dark urine
Diarrhea
Fever

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Mortality risks

Direct relation of magnitude of the case
Treatment of the sickness
Health of the infected individuals immune system
-Seeing an increase in types A & B in middle ages

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Hepatitis A

Does not lead to a chronic illness
Spread by fecal or oral routes
Contaminated food/water

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How is Hep A spread?

Fecal oral route

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Can Hep A lead to chronic disease?

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Hepatitis A symptoms

Symptoms appear 2-6 weeks after exposure
Last several weeks to months
Severity of symptoms vary
Age is variable
**Once you have recovered from the disease, you are immune for life
Rarely fatal
Can be infectious 2 weeks prior to symptoms

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T/F with Hep A once you have recovered from the disease you are immune for life?

True

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Geographical distributions of Hep A

Areas with high levels of infections-poor undeveloped countries, 90% of children infected <10yrs of age
Areas with intermediate levels of infection-developing countries, children often escape infection in early childhood and higher susceptibility in adults
Areas with low levels of infection- developed countries, higher susceptibility in adults

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HAV virus Diagnosis, TX and prevention

Dx: Blood test
Tx: Immunoglobulin for Sx, healthy diet, lots of fluids, no ETOH and avoid some meds
P: Vaccination, sanitary practices, travelers

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Who gets HAV vaccination?

Anyone >1 yr
Men who have sex with men
IV drug use
Childcare centers
Nursing homes

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Who shouldn’t get HAV vaccination?

Children <1yr

Pregnant or nursing mothers

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Hepatitis B- HBV Transmission

Blood, semen, vaginal fluids, and other body fluids

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HBV S/Sx

No Sx
Feel sick for a period of days or weeks
May become very ill (fulminate hepatitis)
** Acute cases and CAN become CHRONIC

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**Kids are more likely to develop chronic infection

<1 yr = 90% chance

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T/F Most adults are not able to clear an HBV infection

False; Most can on 25% cases become chronic

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Incubation period of HBV

average 90 days

-Virus can be detected 30-60 days after infection and persists for variable periods of time.

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** HBsAG- hepatitis B surface antigen

first to show abnormal results: reflects ACUTE issue

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** HBsAb

Sign of Immunity to subsequent infection.
Appears 4 weeks after HBsAg disappears
Signifies end of an acute infection phase

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Which signifies the end of an acute infection phase: HBsAg or HBsAb?

HBsAb

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A pt. has come into the hospital with RUQ pain and has a positive HBsAg what does this mean?

An acute case of hepatitis

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Where is HBV endemic?

China and other parts of Asia
Middle east and indian subcontinent where 2-5% is chronic
<1% of wester Europe and north america

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Which type of Hepatitis is greatly underreported?

Type B

HBV Dx, Tx and Prevention

Dx: Blood test
Tx: Medications, rest and diet
P: Risk behaviors, VACCINATION
* don’t share toothbrushes or nail clippers

Who should receive HBV vaccination?

All children receive 1st dose at birth and complete series by 6 months

healthcare workers
Men who have sex with men
Those with mult. sex partners
IV drugs
household contacts partners with HBV

Hep C

Most common chronic bloodborne infection in US Incubation period is 2 weeks to 6 months 80% people do not exhibit symptoms Usually Sx appear when cirrhosis develops

Incubation period of Hep C

2 weeks to 6 months

In which type of Hepatitis do 80% not show symptoms and symptoms usually first appear when cirrhosis develops

Type C

Acute phase of Hep C

Occurs in first 6 months after exposure Can be short-term but often leads to chronic REINFECTION IS POSSIBLE 15-25% able to clear infection

T/F Once you have Hep C you are immune for life

FALSE; Being infected once does not make you immune

Chronic phase of Hep C

Lifelong infection if left untreated | Can lead to cirrhosis, cancer, death

This risk factor applies to which type of hepatitis: Received a blood transfusion before July 1992

Type C

T/F kids born to Hep C mom; chronic development is 20% better than Hep B

True

Geographical distribution: Highest rates (3 countries)

Egypt, Pakistan and China | - attributed to unsafe injections using contaminated equipment.

In which age groups is HCV the highest

the youngest and the oldest

HCV diagnosis

``` Blood tests Intermittent test for viral load Genetic testing-six genotypes exist -Genotype I in US Liver Biopsy ```

HCV prevention

No vaccination Avoid contact with blood or blood products whenever possible -Sexual transmission is very low among stable monogamous couples

Is there an HCV vaccination?

HCV treatment

Hep C is curable using antivirals Remove the virus from the blood and reduce the risk of cirrhosis and liver cancer Most patients receive weekly injections or pegylated interferon alfa Ribavirin is a capsule taken BID Treatment is given for 24-48 weeks **Also recommended to get A and B vaccinations

T/F Hep C is CURABLE with the use of antivirals

True

How long to HCV treatment usually?

24-48 weeks

Hep C and B healthcare workers Preventions

HCW HEP B vaccine PPE Standard precautions

Hepatitis D

Transmission via blood and body fluids; same as B For transmission, HBV MUST BE PRESENT Usually resolves in a few months Same prevention as other blood born hepatitis PREVENTION: vaccination for HBV

Which type of hepatitis require Hep B to be present?

Hep D

Hepatitis E

``` Transmits via fecal contaminants Mostly ages 15-40 Diagnosis stool sample No vaccine in US Tx and prevention same as HAV. ```

Hep E transmission

Fecal transmission

Hep E diagnosis

Stool sample

Hep E occur most in which age group

15-40

Hep E prevention

Vaccination- only in china Travelling Sanitary practices

Surveillance

Determining he mode of transmission ID the population specifically exposed to increased risk of infection Eliminating a common source of infection Improving sanitary and hygienic practices to eliminate fecal contamination of food and water.

Public health management

All professional staff on high alert for hepatitis Screening panels ordered on all symptomatic persons Confirmed cases immediately report to state health department and Billings area IHS office; federal, state, county, tribal.

Where do we find cases of hepatitis?

``` ER's Treatment centers Homeless sites Adults book stores, massage parlors Family planning Institutional settings; mental health facilities, nursing homes. ```

Public health measures

Raising awareness, promoting partnerships and mobilizing resources; Evidence-based policy and data for action Prevention of transmission and screening care and treatment

Health education

Creative marketing- offering food at educational events Media-campaigns Pamphlets, posters, newspapers articles