Week 205 - Alocoholism and Hepatitis Flashcards
Name 9 types/causes of hepatitis.
Viral - A, B, C, D, E; Alcoholic hepatitis; Autoimmune; Epstein-Barr (EMV); Cytomegalovirus (CVM)
Which types of hepatitis are common?
Hep A, B, C and alcoholic hepatitis
Which viral forms of hepatitis are parenteral and which are oral/faecal?
Parenteral: Hep b, c and D
Oral/faecal: Hep A and E
What is unique about hep D?
It can only be acquired by someone also infected with active Hep B - cannot replicate without it
What are the 3 routes of transmission for viral hepatitis?
1) Oral/faecal
2) Parenteral
3) Blood Products (e.g. transfusion - parenteral also)
What are the common symptoms of viral hepatitis in the prodromal phase?
Flu-like symptoms: nausea/vomiting, malaise, fatigue, anorexia, low-grade fever, myalgia, mild headache.
What does icterus mean?
It is another term for jaundice and the associated symptoms
What are the common signs & symptoms of viral hepatitis in the icteric phase?
- jaundice - itching (pruritis) - abdo pain - dark urine - pale faeces - arthralgia and skin rash
List 3 other differeintials you ought to consider with the icteric picture.
1) Acute HIV infection
2) Acute drug-induced liver injury (e.g. paracetamol/ecstasy etc)
3) Drug-induced hypersensitivity reaction e.g. sulfasalazine hypersensitivity
What are you likely to see/find on examination in someone presenting with viral hepatitis?
jaundice - sclera first then skin; hepatomegaly; temperature of up to 40; features of chronic liver disease; evidence of decompensation
List some signs consistent with decompensated liver disease.
Encephalopathy - drowsiness, liver flap, hyperventilation
Excretory dysfunction - jaundice
Portal HTN / hypoalbuminaemia - ascites, peripheral oedema, leukonychia
Coagulopathy - bruising
Acid-base imbalance - respiratory acidosis
List 7 investigatory tests you’d run with suspected viral hepatitis?
- FBC - U&Es - LFTs
- Clotting - Serology (liver antibodies, viral) - PCR (virus)
- USS
What viral hepatitis types do we give have vaccines for in England and Wales?
Hep A, B and E
What is genetically different about Hep B compared with A, C, D and E?
It is the only one that is composed of DNA rather than RNA
Where is hep E more commonly found globally?
Mexico, North Africa, Asia
What’s the average incubation period for Hep E?
40 days
What is the cause of most outbreaks of Hep E?
Faecally contaminated water
What should you ask any patient about of whom you suspect may Hep E?
Recent Foreign Travel
Where is hep B more commonly found globally?
Central Africa and China & SE Asia
Globally a huge problem - approx. 2 deaths a min!
What are the aims of Hep B (HBV) therapy?
1) Loss of: replication, e antigen, surface antigen
2) Normalisation of transaminases (ALT and AST)
3) Improve of liver histology
