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Y3R5: Medicine I 🩺 > L3: Acute Hepatitis & Acute Liver Failure > Flashcards

L3: Acute Hepatitis & Acute Liver Failure Flashcards

1
Q

Def of Acute Hepatitis

A
  • Acute Inflammation of the hepatic parenchyma or injury to hepatocytes resulting in elevated liver function indices
  • Duration → less than 6 months
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2
Q

Etiology of Acute Hepatitis

A
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3
Q

Compare between HAV,HBV,HCV,HDV,HEV

in terms of:

  • Genome
  • Transmission
  • IP
  • Fulminant
  • Chronicity
  • Prophylaxis
  • Serology
A
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4
Q

CP of Acute Hepatitis

A
  • Asymptomatic
  • Non-Icteric Hepatitis
  • Icteric Hepatitis
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5
Q

non-icteric Acute Viral Hepatitis

A

(without jaundice)

  • Flu like symptoms: Fever, Headache, Malaise, Anorexia
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6
Q

Icteric Acute Viral Hepatitis

A
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7
Q

Sequale of Acute Viral Hepatitis

A
  • Complete Recovery
  • Complications
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8
Q

Complications of Acute Viral Hepatitis

A
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9
Q

which virus is related to this complication (Prolonged Cholestasis)?

A

HAV

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10
Q

which virus is related to this complication (Relapse)?

A

HAV

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11
Q

which virus is related to this complication (Chronicity)?

A

B - C - D

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12
Q

which virus is related to this complication (Extrahepatic Complications) ?

A
  • HBV → serum sickness like syndrome (arthralgia, rash, angioedema)
  • HCV: → Essential mixed cryoglobulinemia (arthralgia, palpable purpura, weakness, glomerulonephritis )
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13
Q

Investigations for Acute Viral Hepatitis

A
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14
Q

Prevention of Acute Viral Hepatitis

A
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15
Q

Managment of Acute Viral Hepatitis

A
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16
Q

Supportive Measures in Acute Viral Hepatitis

A
  • Diet (high calorie diet)
  • Hydration (IV fluid if vomiting is severe)
  • Bed rest (or activity as tolerated)
  • Avoid drugs metabolized by liver
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17
Q

Symptomatic TTT in Acute Viral Hepatitis

A
  • Vomiting: Anti‐emetics
  • Itching: Cholestyramine
18
Q

Management of Complications in Acute Viral Hepatitis

A

Acute (fulminant) liver failure: Hospitalization and appropriate management

19
Q

Specific Therapy in Acute Viral Hepatitis

A

HCV: spontaneous recovery only (15‐20%)
- Direct acting antivirals

HBV: in special cases (severe acute hepatitis)
- Oral nucleoside

20
Q

Characters of Acute Hepatitis A

A
21
Q

Def of Acute Liver Failure

A
  • Rapid deterioration in liver function characterized by →coagulopathy (INR > 1.5) and encephalopathy, in patients without pre-existing liver disease.
  • Duration → < 26 weeks
22
Q

Other terms of Acute Liver Failure

A
  • Fulminant Hepatic Failure
  • Fulminant Hepatitis
23
Q

Classification of Acute Liver Failure

A
24
Q

Etiology of Acute Liver Failure

A
25
Q

Viral Causes of Acute Liver Failure

A
  • Hepatitis → B, A, E
  • Less frequent → CMV, HSV, VZV, Dengue
26
Q

Drug Causes of Acute Liver Failure

A
  • Paracetamol (dose dependent)
  • INH, chemotherapy, statins
  • NSAIDs
27
Q

Vascular Causes of Acute Liver Failure

A
  • Budd–Chiari syndrome
  • Hypoxic hepatitis
28
Q

Toxin Causes of Acute Liver Failure

A
  • Amanita phalloides
  • Phosphorus
29
Q

Other causes of Acute Liver Failure

A
  • Wilson disease, autoimmune
  • Acute fatty liver of pregnancy
30
Q

what is the does of paracetamol that causes acute liver failure?

A

> 15 gm

31
Q

What is The commonest cause of ALF in the UK and the USA?

A

Paracetamol

32
Q

…… may influence the liver susceptibility to lower doses of acetaminophen.

A

Alcohol abuse

33
Q

what are other hepatotoxic drugs?

A

Idiosyncratic (not dose dependent)
- Such as: →INH, chemotherapy, statins, NSAIDs

34
Q

Pathophysiology of Acute Liver Failure

A
35
Q

CP of Acute Liver Failure

A
36
Q

Investigations of Acute Liver Failure

A
  • Investigations to assess liver functions and complications
  • Investigations to diagnose the cause
37
Q

Investigations to assess liver functions and complications in Acute Liver Failure

A
38
Q

Investigations to diagnose the cause of Acute Liver Failure

A
39
Q

Managment of Acute Liver Failure

A
40
Q

Etiology-specific therapies in Acute Liver Failure

A
41
Q

Supportive care in ICU in Acute Liver Failure

A
  • Monitor level of consciousness
  • Correct hypoglycemia
  • Prevent GI bleeding with PPI
  • Monitor for infection and multiorgan failure
42
Q

What is The only effective therapy for ALF patients who fail to recover spontaneously?

A

Liver transplantation

Y3R5: Medicine I 🩺 (47 decks)

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