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NURS 2514 > Week 7 - Hepatitis > Flashcards

Week 7 - Hepatitis Flashcards

1
Q

what are 4 types of disorders of the liver

A
  • viral hepatitis
  • toxic & drug induced hepatitis
  • nonalcoholic fatty liver disease
  • nonalcoholic steatohepatitis
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2
Q

what is viral hepatitis

A
  • inflammation of the liver due to viral infection
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3
Q

what are the 3 most common viral agents that cause hepatitis

A
  • hepatitis A virus
  • hepatitis B virus
  • hepatitis C virus
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4
Q

what are 6 other causes of viral hepatitis

A
  • hepatitis D virus
  • epstein-barr virus
  • cytomegalovirus
  • herpes simplex
  • rubella
  • yellow fever
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5
Q

what do the viruses that cause hepatitis have the ability to cause (2)

A
  • cause chronic infections

- be carried by a host in the absence of symptoms (= carrier)

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6
Q

how do viral infections cause liver cell damage (2)

A
  • direct toxic affect on hepatocytes

- immune-mediated cell death

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7
Q

how is hep A transmitted

A
  • oral-fecal route
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8
Q

can hep A be carried by a host in the absence of symptoms?

A
  • no
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9
Q

what is the incubation period of hep A

A
  • 2-6 weeks
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10
Q

how is hep B transmitted

A
  • blood & body fluids
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11
Q

what is in the incubation period of hep B

A
  • 2-3 months
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12
Q

can hep B cause chronic infections & carriers?

A
  • yes
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13
Q

how is hep C transmitted

A
  • blood & body fluids
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14
Q

what is in the incubation period of hep C

A
  • 6-9 weeks
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15
Q

can hep C cause chronic infections & carriers

A
  • yes
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16
Q

what are the 3 phases of hepatitis

A
  • preicterus (prodrome) phase
  • icterus (acute) phase
  • posticterus (convalescent) phase
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17
Q

what symptoms are present during the preicterus phase of hepatitis (3)

A
  • nonspecific signs of infection
  • general GI S+S
  • RUQ abdominal discomfort
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18
Q

what are some nonspecific signs of infection (4)

A
  • malaise
  • fatigue
  • myalgia
  • mild fever
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19
Q

what are some general GI S+S (3)

A
  • anorexia

- NV

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20
Q

what symptoms are present during the icterus phase of hepatitis (4)

A
  • enlarged liver & RUQ pain continues
  • hepatic jaundice (& its S+S, pale stool, dark urine, etc.)
  • coagulopathy
  • encephalopathy
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21
Q

why do we get coagulopathy during the icterus phase of hepatitis

A
  • due to hepatic jaundice –> impaired coagulation factor synthesis
  • impaired vitamin K absorption (cholestasis)
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22
Q

why does encephalopathy occur during the icterus phase of hepatitis

A
  • may or may not occur if the hepatitis is severe & causes the liver to start to fail
  • when the liver can no longer produce urea = toxic levels of ammonia rise
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23
Q

how is the extent of liver necrosis measured?

A
  • by testing the blood for elevation of liver-specific enzymes
24
Q

what are 2 types of liver specific enzymes

A
  • aspartate aminotransferase (AST)

- alanine aminotransferase (ALT)

25
Q

what symptoms are present during the posticterus phase of hepatitis

A
  • improvement of general signs & symptoms

- persistent abnormalities in liver function tests

26
Q

see table 46-2 in joes notes for long list acute symptoms of hepatits

A

…

27
Q

what symptoms are present in chronic hepatitis (5)

A
  • malaise
  • easy fatigability
  • myalgia
  • arthralgia
  • hepatomegaly
28
Q

who does hep A commonly effect (4)

A
  • children
  • young adults
  • care givers
  • travellers
29
Q

where does hep A commonly occur

A
  • daycares

- schools

30
Q

how does HAV effect the liver

A
  • multiples within & kills hepatocytes = directly toxic
31
Q

how harmful in hep A

A
  • benign & self-limiting process

- fatalities can occur

32
Q

is vaccination availble for hep A

A
  • yes
33
Q

describe immunity to hep A after infection

A
  • following recovery, IgGs persist in the blood indefinitely = immunity
34
Q

what antibody is always first during infection

A

IgM

35
Q
  • list different ways hep B is transmitted (5)
A
  • contaminated blood
  • semen
  • birth
  • maternallu
  • salivia
36
Q

describe how harmful hep B is

A
  • most people survive the intial acute hepatitis
  • 1% develop fulminant liver failure = death
  • 10% adults, 80% infants develop lifelong chronic hepatitis and ultimately cirrhosis
37
Q

what does hep B increase the risk of

A

liver cancer

38
Q

how is hep B treated

A
  • interferon

- nucleosides & nucleotide analogues

39
Q

what do interferons do

A
  • interfere with viral replication (antiviral)

- and activate other cells involved in the immune system (immunomodulatory)

40
Q

what are nucleoside & nucleotide analogues

A
  • inhibit viral DNA synthesis
41
Q

how is hep B prevented

A
  • vaccination & passive immunity
42
Q

how does passive immunity work

A
  • take hep B surface antigen and give to B lymph in culture
  • this tricks the lymphocytes into making antibodies for the Hep B antigen
  • these antibodies are purified & infected into people
43
Q

what is passive immunity good for

A
  • people who are accutely exposed to hep B

- gives an immediate rxn where it neutralized the virus before infection

44
Q

describe how hep C is transmitted

A
  • similar to HBV but less virulent
45
Q

describe how harmful hep C is

A
  • only half of those infected develop acute hep

- but 50% of the acute phases progress to chronic hepatitis

46
Q

is there a vaccination available for hep C

A
  • no
47
Q

what is treatment for hep C

A
  • interferon (but is only useful for some)
48
Q

know the charts for hep???

A

….

49
Q

what are 4 other types of hepatitis

A
  • D
  • E
  • F
  • G
50
Q

what is hepatitis D

A
  • considered an incomplete virus
51
Q

what is meant by “incomplete virus”

A
  • unable to make its own surface protein

= borrows this capsule protein from HBV

52
Q

describe how infection with hep D occurs

A
  • can only occur if a person is infected with HBV

- HBV and HDV can occur simultaneously, or in a chronic hep B case

53
Q

what does HDV infection frequently result in

A
  • fulminant hepatic failure
54
Q

how is HDV prevented?

A
  • no vaccine available

- but vaccination against HBV prevents HDV in unexposed people

55
Q

how do viral infections cause inflammation of the liver

A
  • the infection triggers the immune system

- the immune cells then trigger cytotoxic killing of the infected hepatocytes = cell apoptosis = inflammation

56
Q

what can hepatitis lead to

A
  • liver damage & cirrhosis

NURS 2514 (75 decks)

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