Liver Infection- Hepatitis Flashcards
What are the functions of the liver?
*maintain homeostasis
*detoxification
*metabolism
*storage
*synthesis
What are the clinical spectrums of viral hepatitis?
*Acute Hepatitis- resolves within 6 months. May be asymptomatic
*Acute fulminant hepatitis- rapid severe necrosis of hepatocytes. Rare, life threatening
*Chronic Hepatitis- ongoing > 6 months
*Carrier state- harbour virus. Asymptomatic
What are some acute hepatitis symptoms?
Flu-like
*fatigue
*malaise
*low grade fever
GI
*nausea
*vomit
*upper right quadrant abdominal pain
*constipation
General
*itch/urticaria (hives)
What are some later symptoms of acute hepatitis?
*jaundice (icterus)
*pale stools
*pruritis (itch)
*hepatic tenderness
What type of virus is hepatitis A?
Non enveloped single stranded virus
How is hepatitis A transmitted?
Faecal oral route
How is hepatitis A diagnosed?
*acute illness with discrete symptoms
*jaundice
*^ serum aminotransferase levels
*present IgM and IgG antibodies to HAV
What pain management should be avoided in severe liver impairment?
Codeine
State 2 ways to avoid contracting hepatitis A
*good personal hygiene
*travellers to endemic areas should avoid food and water potentially contaminated with feces
What type of virus is hepatitis B?
Enveloped DNA virus
How is hepatitis B transmitted?
Blood, genital fluids or mother to baby.
Who are high risk groups for hepatitis B?
*injecting drug users
*people who change sexual partners regularly
*sex workers
*people with chronic liver failure
How is hepatitis B diagnosed?
*jaundice
*IgM antibody present
*HBsAG (antigen) present
*LFT’s- ^ bilirubin
What drugs are used to treat chronic hepatitis B?
Interferon Alfa
Antivirals
*entacavir
*tenofovir disoproxil
What advice is given to patients with hepatitis B?
*avoid alcohol- ^ cirrhosis, liver failure and hepatocellular cancer
*avoid needle sharing
*avoid unprotected sex
How to prevent active hepatitis B?
*vaccine pre or post exposure
*immunoglobulin prophylaxis- temporary immunity until vaccine responds
How is hepatitis C transmitted?
Blood borne. Blood and genital fluid
How is hepatitis C diagnosed?
*anti HCV antibody present
*abnormal lft’s
*symptoms- jaundice, weight loss
What immunisations should a patient with hepatitis C receive?
*hepatitis A and B vax
*penumonococcal
What drugs are used in treating hepatitis C?
Direct Acting Antivirals (combination therapy)
*sofosbuvir
What causes fungal hepatitis?
Haematogenous dissemination (spreading in blood)- Candida
Can hepatitis A be chronic?
No
