Viral Hepatitis Flashcards
hepatitis
inflm of liver
etiology of hepatitis
- microbes cause an infection in the liver (usually viral)
- hepatotoxic drugs
- autoimmune hepatitis
- secondary to systemic problems (ex. Epstein-Barr virus, cytomegalovirus)
viral hepatitis types from most severe to least
hepatitis C (most) hepatitis B hepatitis A (least)
hepatitis A acute or chronic
- mild, acute
- self-limiting
how is hepatitis A transmitted
oral-fecal transmission (ex. outbreak in fast food restaurants, water and ice in developing countries)
hepatitis B acute or chronic
can be both
hepatitis B carrier state
pt can harbour virus and pass on even if hepatitis is not active
hepatitis B transmission
- blood
- most bodily fluids
- oral
- sexual
anti-hepatitis B Abs
anti-HBs
anti-HBc
anti-HBe
anti-HBs
anti-HBc
anti-HBe
s = Ag on surface of virus c = Ag on core of virus e = Ag on core of virus and immediately surrounding core
hepatitis C acute or chronic
chronic (80%) –> cirrhosis and hepatocellular CA
hepatitis C transmission
- infected blood
- organs
what population high hepatitis C
IV drug users
those engaging in high risk sex practices
hepatitis C Dx
HCV (hep C virus) Abs and viral tests
PCR
2 mechanisms of viral hepatitis
1) virus invades host cell, replicates and lyses cell
2) inflm induced by viral injury
in hepatitis, virus targets which cell
hepatocytes –> compromised liver fx
inflm induced by viral injury consequences
damaged vessels –> necrosis
damaged bile ducts –> GI dysfx
3 phases of presentation
1) prodromal
2) clinical (post-prodromal)
3) recovery phase
prodromal symptoms
range from insidious - symptomatic
- lethargy
- myalgia
- generalized weakness
- anorexia
- N/V
- fever
- abd pain
why does myalgia occur
liver produces metabolites for other cells –> less ATP production = muscle weakness
why does N/V occur
liver is an accessory organ of the GI tract
clinical phase symptoms
- prodromal mnfts worsen
- liver tender & swollen (sore on palpation)
- jaundice
- pruritus
why does jaundice occur
liver’s l/o fx to excrete bilirubin and it buildsup in the bloodstream
why does pruritis occur
bile salts accumulate (b/c of damaged bile ducts) and deposit in skin
how long does recovery take in recovery phase
full recovery in approx 16 wks (4 mo)
when is clinical phase
5-10 days after prodromal phase
tx for hepatitis
- dec workload on liver
- no alcohol or hepatotoxic drugs
- symptomatic management
- vaccines for hep A&B
- newer drugs –> direct acting antivirals (DAA) for hep C
- non-antivirals (ex. interferons)
how to dec workload on liver
bedrest diet restriction (high calorie w/ more protein, less fat)
