Viral Hepatitis

Question 1

hepatitis

Answer 1

inflm of liver

Question 2

etiology of hepatitis

Answer 2

• microbes cause an infection in the liver (usually viral)
• hepatotoxic drugs
• autoimmune hepatitis
• secondary to systemic problems (ex. Epstein-Barr virus, cytomegalovirus)

Question 3

viral hepatitis types from most severe to least

Answer 3

hepatitis C (most) 
hepatitis B 
hepatitis A (least)

Question 4

hepatitis A acute or chronic

Answer 4

• mild, acute

- self-limiting

Question 5

how is hepatitis A transmitted

Answer 5

oral-fecal transmission (ex. outbreak in fast food restaurants, water and ice in developing countries)

Question 6

hepatitis B acute or chronic

Answer 6

can be both

Question 7

hepatitis B carrier state

Answer 7

pt can harbour virus and pass on even if hepatitis is not active

Question 8

hepatitis B transmission

Answer 8

• blood
• most bodily fluids
• oral
• sexual

Question 9

anti-hepatitis B Abs

Answer 9

anti-HBs
anti-HBc
anti-HBe

Question 10

anti-HBs
anti-HBc
anti-HBe

Answer 10

s = Ag on surface of virus 
c = Ag on core of virus 
e = Ag on core of virus and immediately surrounding core

Question 11

hepatitis C acute or chronic

Answer 11

chronic (80%) –> cirrhosis and hepatocellular CA

Question 12

hepatitis C transmission

Answer 12

• infected blood

- organs

Question 13

what population high hepatitis C

Answer 13

IV drug users

those engaging in high risk sex practices

Question 14

hepatitis C Dx

Answer 14

HCV (hep C virus) Abs and viral tests

PCR

Question 15

2 mechanisms of viral hepatitis

Answer 15

1) virus invades host cell, replicates and lyses cell

2) inflm induced by viral injury

Question 16

in hepatitis, virus targets which cell

Answer 16

hepatocytes –> compromised liver fx

Question 17

inflm induced by viral injury consequences

Answer 17

damaged vessels –> necrosis

damaged bile ducts –> GI dysfx

Question 18

3 phases of presentation

Answer 18

1) prodromal
2) clinical (post-prodromal)
3) recovery phase

Question 19

prodromal symptoms

Answer 19

range from insidious - symptomatic

• lethargy
• myalgia
• generalized weakness
• anorexia
• N/V
• fever
• abd pain

Question 20

why does myalgia occur

Answer 20

liver produces metabolites for other cells –> less ATP production = muscle weakness

Question 21

why does N/V occur

Answer 21

liver is an accessory organ of the GI tract

Question 22

clinical phase symptoms

Answer 22

• prodromal mnfts worsen
• liver tender & swollen (sore on palpation)
• jaundice
• pruritus

Question 23

why does jaundice occur

Answer 23

liver’s l/o fx to excrete bilirubin and it buildsup in the bloodstream

Question 24

why does pruritis occur

Answer 24

bile salts accumulate (b/c of damaged bile ducts) and deposit in skin

Question 25

how long does recovery take in recovery phase

Answer 25

full recovery in approx 16 wks (4 mo)

Question 26

when is clinical phase

Answer 26

5-10 days after prodromal phase

Question 27

tx for hepatitis

Answer 27

• 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)

Question 28

how to dec workload on liver

Answer 28

bedrest 
diet restriction (high calorie w/ more protein, less fat)