Week 4 Hepatitis Flashcards
What are the most common types of hepatitis in canada
A, B, C
What is hepatomegaly
an enlarged liver
what is the most severe form of Nonalcoholic Fatty Liver Disease and what does this mean
non-alcoholic steatohepatitis (NASH) which means that fatty build up has started to damage liver cells resulting in fibrosis
what is Metabolic dysfunction-associates steatotic liver disease
when fat builds up in the liver and causes inflammation and possibly cirrhosis (previously known as NAFLD)
what are risk factors for MASLD
-Obesity
-Type 2 DM
-increased age
What would it mean if AST was elevated
Indicates that there is inflammation of an organ but not specific to a single organ (the “S” stands for several organs
What would an elevated ALT level indicate
Specifically indicates liver inflammation
What would an elevated GGT level indicate
Indicates Cholecystitis and alcohol induced fatty liver disease (Stands for “Get Me Another Drink”)
What does an elevated ALP level indicate
-Can indicate liver disease (but is not specific to the liver)
-Bone disease (ie bone CA)
What might Albumin Bilirubin and INR levels look like in a patient with liver disease
-Decreased Albumin (since the liver isn’t functioning properly can’t create enough)
-Increased bilirubin (Since the liver excretes bilirubin if it’s not working properly it will build up in the blood)
-Increased INR (since the liver produces platelets if its not functioning properly the blood will take longer to clot)
How is hepatitis A spread
spread via the fecal oral route
If a person had the IgM antibodies to hepatitis A what would that indicate
Would indicate that there is an acute infection going on
if a person had the IgG antibody to hepatitis A what would that indicate
would indicate that the person has had exposure to Hep A in the past either through vaccination or the disease itself and now has immunity
what would it indicate if someone had a negative IgM to hep A but a positive IgG
means they are not experiencing an acute infection but they have been exposed in the past either by vaccination or having the disease in the past
Can Hep A result in a chronic carrier state*
No the disease is self limiting and fully resolves with no lasting effects and people do not remain contagious if they have had the disease
Are there scheduled vaccines for Hepatitis A
No only people who are at high risk receive a vaccine
are there scheduled vaccines for hepatitis B
yes immunizations are scheduled at 2, 4 and 6 months
how is hepatitis B spread
spread via blood and bodily fluids
What does Hepatitis B surface antigen indicate
Indicates that a person currently has hepatitis B (so can be present in an acute or chronic infection just not in a resolved infection)
What does Anti hepatitis B surface antibodies indicate
Means that someone has been exposed either through vaccination or infection and is now immune
What does Total Antibody to Hepatitis B Virus core Antigen indicate
Indicates an acute chronic or resolved infection
what would someones Hepatitis B serology look like if they had a resolved Hep B
-Negative HB Surface AG
-Positive Anti Hep B Surface Antibodies
-Positive Total AB to HBV Core Antigen
what would someones Hep B serology look like if they had a chronic Hep B infection
-Positive HB Surface AG
-Negative Anti Hep B Surface Antibodies (because they still have the infection they did not develop immunity)
-Positive Total AB to HBV Core Antigen
Is there a vaccine for hepatitis C
No there is no Hepatitis C vaccine
What do Antibodies to the hepatitis C virus indicate
Means someone has been infected with hepatitis C at some point and produced antibodies to the virus
What does a Hepatitis C RNA/Viral load test indicate
Indicates if someone has a current acute or chronic infection
how is Hep C transmitted
Blood and Body fluids but especially blood from below the SubQ tissue
how is Hepatitis D spread
-First the person has to of had a Hep B infection
-then it is spread percutaneously (so through the skin; ie sharps injury or body fluids coming into contact with mucosal linings)
how is hepatitis E spread
Via the fecal oral route
What are some symptoms that are specific to an acute hepatitis infection
-Arthralgias (pain in joints)
-Rashes
-RUQ pain
-May find food, alcohol or if there a smoker cigarettes distasteful
-May or may not have jaundice
What is fulminant hepatitis and what type of hepatitis may cause this
syndrome that results in severe impairment or necrosis of the liver and potentially liver failure that can result from a Hep B and D co infection
Can serum liver tests differentiate between types of hepatitis
No they can only determine if the problem is a liver cell injury or bile duct problem
In deteriorating liver function what would INR, Bilirubin and albumin levels look like
-INR would increase (less clotting)
-Bilirubin would increase
-Albumin would be decreased
When would Hep A immunoglobulin be administered
Can be administered before or after exposure to mitigate the effects of the virus
how long after exposure to Hep A can immunoglobulin be administered and it would still be effective
can be administered 1-2 weeks after exposure and still be effective
how long does Hep A immunoglobulin provide immunity for
provides immunity for 6-8 weeks
which age demographic is most likely to contract a chronic Hep B infection
Newborns/children (95% of adults clear the infection unless they are immunocompromised)
do people who are infected with hepatitis C commonly have signs or symptoms
No most people exhibit no symptoms
How common is it for people infected with hepatitis C to develop a chronic infection
the majority of people who have Hep C will develop a chronic infection
Does hepatitis C increase a person’s risk for developing liver cancer
Yes Hep C significantly increases your chances of getting liver cancer
How is Hep C treated
with direct acting antivirals which can completely eradicate the virus
what kind of medications most commonly cause drug induced liver injuries
-Antibiotics
-Acetaminophen q
What is hereditary hemochromatosis
Genetic disorder that leads to increased iron absorption
what is primary biliary cholangitis
Progressive destruction of the bile ducts by the immune system that results in total blockage of bile flow
What is primary sclerosing cholangitis
Inflammation of the bile ducts in the liver which can lead to blockage
If someone liver panels were elevated what types of medications may be held
-Acetaminophen
-some antibiotics
which Liver panel test most accurately reflects damage to the hepatocytes
ALT
what is the most common treatment for hepatitis B
Supportive care
what is a very common way that hepatitis A is spread
by drinking contaminated water in developing countries
What is a normal result for an INR test
0.8-1.2
what INR result would indicate that warfarin is working to prevent blood clots
2.0-3.0
what is a critical value for INR
5 and above
If AST ALT GGT were elevated what might be a priority assessment for a nurse
Bleeding since this indicates the liver is not functioning properly all together so its probably not producing platelets correctly
