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Pathopharmacology I > Wk 4 Hepatitis > Flashcards

Wk 4 Hepatitis Flashcards

1
Q

Hep E and D are…

A

not common in USA

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2
Q

What are 2 other viruses that can cause hepatitis

A

Epstein-Barr

Cytomegalovirus

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3
Q

Hepatitis can have other causes not from a virus such as… (4)

A

Alcohol abuse
Drugs
Chemicals
Bacteria

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4
Q

What are the most common strains of viral hepatitis?

A

B and C

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5
Q

What type of viral hepatitis is VERY dangerous in pregnancies?

A

E

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6
Q

What is the pathogenesis of viral hepatitis?

A

Infection which leads to inflammatory mediators that cluster around liver, causing lysis of cells and death, then tissue hypoxia. End result: edema and swelling

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7
Q

In many cases __ types of viral hepatitis are asymptomatic

A

ALL

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8
Q

Viral hepatitis causes elevated __

A

LFTs

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9
Q

Viral hepatitis is NOT consistent with…

A

cellular damage within the liver

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10
Q

When is the prodromal stage of viral hepatitis?

A

2 weeks after exposure

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11
Q

In the prodromal phase, viral hepatitis is __ __.

A

highly transmissible

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12
Q

What are the symptoms of the prodromal phase of viral hepatitis?

A 
Fatigue
Anorexia
Malaise 
Nausea
Vomiting
HA
hyperalgesia
cough 
low grade fever
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13
Q

What is hyperalgesia?

A

Extreme sensitivity to pain

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14
Q

When is the icteric phase of viral hepatitis?

A

Begins with jaundice

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15
Q

What happens to the liver in the icteric phase of viral hepatitis?

A

Liver is enlarged and may be painful to palpation

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16
Q

What are symptoms of the icteric phase of viral hepatitis?

A 
jaundice
dark urine
clay-colored stools
fatigue
abdominal pain
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17
Q

What is different about the abdominal pain in the icteric phase versus the prodromal phase of viral hepatitis?

A

It either persists or increases in severity

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18
Q

After the icteric phase, what can happen to a patient with viral hepatitis?

A

They can develop chronic hepatitis

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19
Q

What is the recovery phase of viral hepatitis?

A

Resolution of jaundice

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20
Q

When is the recovery phase of viral hepatitis?

A

6-8 weeks after exposure with diminished symptoms

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21
Q

What is something important to note about the recovery phase of viral hepatitis?

A

Liver remains enlarged/tender

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22
Q

Most patients with acute viral hepatitis…

A

recover completely with no complications

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23
Q

What is the overall mortality rate for viral hepatitis?

A

Less than 1% unless the patient is elderly or has comorbidities

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24
Q

What are 4 potential complications of viral hepatitis?

A

Chronic hepatitis
Liver cirrhosis
Liver cancer
Fulminant viral hepatitis - acute liver failure

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25
Q

Hep A is considered a…

A

food borne illness related to unclean sanitation and improper handling of food

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26
Q

What is the transmission of hepatitis A?

A

Mainly fecal-oral

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27
Q

What other ways can hepatitis A be spread?

A

Parenteral or sexually

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28
Q

What is the severity of hepatitis A?

A

Usually mild, acute onset

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29
Q

Hepatitis A does NOT lead to what?

A

chronic hepatitis

30
Q

What are the symptoms of hepatitis A?

A 
fatigue
fever
n/v/d
stomach pain
dark pee
clay colored stool
jaundice
31
Q

Who can get hepatitis A?

A

Really anyone, children and adults

32
Q

How do you prevent hepatitis A infection?

A

Hand hygiene

Hepatitis A vaccine

33
Q

How is hepatitis B spread?

A

IV drug use

Sexual contact

34
Q

What is the onset like of hepatitis B?

A

insidious

35
Q

How long is the incubation period of hepatitis B?

A

60-180 days before they may or may not show symptoms

36
Q

How many patients who are infected with hepatitis B will develop chronic hepatitis B?

A

About 10%

37
Q

Hepatitis be is a severe disease and may have a…

A

prolonged course

38
Q

Who can get hepatitis B?

A

Anyone

39
Q

What are 3 ways to prevent hepatitis B?

A

HBV vaccine
Safe sex
Hygiene

40
Q

If hepatitis B becomes chronic, what are 2 complications that can happen?

A

Liver Cancer

Liver failure

41
Q

What is associated with both liver cancer and liver failure?

A

cirrhosis of the liver

42
Q

How is hepatitis C spread?

A 
Parenteral
Sexual
Mother to fetus
Medical mistakes
Sharing toothbrushes or razors
43
Q

What is the onset like of hepatitis C?

A

Insidious

44
Q

What are the severity of the symptoms of hepatitis C?

A

Mild to severe

45
Q

What percent of patients with hepatitis C will develop chronic hepatitis?

A

80%

46
Q

Who can get hepatitis C?

A

Anyone

47
Q

What is important to note about hepatitis C?

A

There is no vaccine

48
Q

What are the symptoms of hepatitis C? (4)

A

No symptoms
Stomach pain
Vomiting
Jaundice

49
Q

What does hepatitis C not spread through? (2)

A

Breast feeding

Insect bites

50
Q

What does hepatitis C lead to? (2)

A

Hepatocellular carcinoma

Need for liver transplant

51
Q

How is hepatitis C prevented? (3)

A

Do not participate in high risk activities
Screen blood
hygiene

52
Q

What is the dosing for the hepatitis A vaccine?

A

2 doses 6 months apart

53
Q

What is the recommendation for getting the hepatitis A vaccine?

A

All children beginning at 12 months

Special high risk populations

54
Q

What is the dosing for the hepatitis B vaccine?

A

3 doses at least 4 months apart

55
Q

Who is recommended to get the hepatitis B vaccine?

A

All infants beginning as newborns

56
Q

What are the two classes of drugs for chronic hepatitis B?

A

Interferons

Nucleoside analogs

57
Q

Why are there 2 classes of drugs we use to treat chronic hepatitis B?

A

Because the virus has mutated causing certain strains to be resistant to treatments

58
Q

Treatment for chronic hepatitis B is reserved for those who are…

A

high-risk patients that are showing liver damage

59
Q

What are 3 indicators of a high-risk patient in need of hepatitis B treatment?

A

Elevated AST levels
Hepatic inflammation
Advanced fibrosis

60
Q

What are the disadvantages of treating hepatitis B?

A

Prolonged therapy
Costs and adverse effects
High relapse

61
Q

The adverse side effects of chronic hepatitis b drugs are…

A

Interfere with a lot of drugs patients may take for other conditions
tone of side effects

62
Q

For hepatitis C, who is treatment recommended for?

A

Only those with chronic disease, but this concept is changing with the introduction of newer drugs

63
Q

Hepatitis C is NOW…

A

Easily treatable and eliminated in most all patients

64
Q

What is chronic hepatitis C treated with?

A

direct-acting antiviral therapy

65
Q

What else might you see being added to the regimen for treatment of hepatitis C? (2)

A

Interferon-based regiments

Nucleoside analogue

66
Q

Direct-acting antiviral therapy drugs are very expensive but…

A

Because they work so well they are considered cost beneficial

67
Q

Can a patient with active/chronic hepatitis take Tylenol?

A

Yes but it is recommended that they take less than 2g a day

68
Q

What is the maximum daily recommendation of Tylenol for someone who does not have liver damage?

A

4g

69
Q

If someone has advanced liver disease we would want to avoid…

A

Tylenol and NSAIDs

70
Q

What is pegylated interferon-alpha is used for what?

A

Hep B

71
Q

Ribavirin is used for what?

A

Hep B

Pathopharmacology I (33 decks)

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