Topic 8: Hepatitis A, B, C

Question 1

Hepatitis

Answer 1

inflammation of the liver, most often caused by viruses, but other causes include substances (alcohol, medications) and autoimmune.

Question 2

Hepatitis A transmission

Answer 2

fecal-oral route (contaminated food or drinking water, poor hygiene or proper handling of food)

Question 3

Hepatitis B transmission

Answer 3

blood borne pathogen, blood and body fluid (IV drug use, tattoos body piercings- contaminated needles, unprotected sex- semen and vaginal secretions, mothers to their infants)

Question 4

Hepatitis C transmission

Answer 4

blood borne primarily transmitted percutaneously (sharing contaminated needles, high risk sexual activities among MSM with HIV infection)

Question 5

Clinical Manifestations for Acute Hepatitis

Answer 5

· Flu-like symptoms (HA)
· Jaundice
· Clay-colored stools
· Dark urine (due to excess bilirubin excreted by kidneys)
· Fatigue, lethargy, malaise
· Low grade fever
· Pruritus
· RUQ tenderness
· Splenomegaly, hepatomegaly
· N/V, diarrhea or constipation
· Decreased sense of taste and smell
· Anorexia and weight loss

Question 6

what is the urine and stool appearance in a patient with acute hepatitis

Answer 6

· Clay-colored stools
· Dark urine (due to excess bilirubin excreted by kidneys)

Question 7

why is pruritus a clinical manifestation of acute hepatitis

Answer 7

due to accumulation of bile salts beneath the skin

Question 8

what location is tenderness felt in a patient with acute hepatitis

Answer 8

RUQ

Question 9

Clinical Manifestations for Chronic Hepatitis

Answer 9

· AST, ALT elevations
· Ascites and lower extremity edema
· Asterixis (“liver flap”)
· Bleeding abnormalities (thrombocytopenia, easy bruising, prolonged clotting time)
· Fatigue, malaise
· Hepatic encephalopathy: confusion, difficulty concentrating, easy agitation
· Increased bilirubin
· Jaundice
· Palmar erythema
· Spider angioma
· Myalgias/arthralgia
· Hepatomegaly

Question 10

diagnostic studies for hepatitis

Answer 10

· To distinguish among the types of viral hepatitis, testing of patients’ blood for specific antigen or antibody
Liver biopsy

Question 11

lab results for hepatitis

Answer 11

increase AST and ALT
increased bilirubin

Question 12

management for acute VIRAL hepatitis

Answer 12

most managed at home
· Adequate nutrition
· Rest the body to help liver regenerate and repair
· Avoid alcohol

Question 13

Health Promotion Hepatitis A

Answer 13

· Hand washing, proper personal hygiene
· Environmental sanitation
· Control and screening of food handlers
· Serologic screening for those carrying the virus
· Active immunization: HAV Vaccine

Question 14

Health Promotion Hepatitis B and C

Answer 14

· Hand washing
· Avoid sharing tooth-brush and razors
· HBIG administration for one-time exposure (needle stick, contact of mucous membranes with infections material
· Active immunization: HBV vaccine
· Condoms for sexual intercourse

Question 15

comfort measures for pruritis

Answer 15

hydration, mosturizer, avoid irritants

Question 16

nutrition for hepatitis

Answer 16

· small frequent meals
· Adequate fluid intake (2500 to 3000 mL/day)

Question 17

Lactulose

Answer 17

given to help reduce ammonia levels in patients presenting with hepatic encephalopathy, excreted through stool

Question 18

what is the most frequent cause of liver disease

Answer 18

alcohol

Question 19

what is the most common cause for acute liver failure

Answer 19

acetaminophen

Question 20

Clinical manifestation of acute alcoholic hepatitis

Answer 20

· Hepatomegaly
· Jaundice
· Elevated liver enzymes
· Low grade fever
· Possible ascites
· Prolonged PT time

Question 21

Drug-induced Liver Injury

Answer 21

· Increase in liver enzymes
Jaundice and in servere cases acute liver failure

Question 22

interventions for drug and chemical induced liver injury

Answer 22

Manifestation may improve if alcohol intake ceases

Patients with chemical hepatotoxicity or Drug-induced Liver Injury should stop all drugs identifies as the cause if liver injury