What is hepatitis and what is it caused by?
*Inflammation of the liver *can be caused by viruses *toxic substances (ETOH, meds, industrial solvents)
When is hepatitis acute vs. chronic?
Acute if 6 motnths or less, chronic if over 6 months
What are the signs and symptoms of hepatitis?
**fatigue, nausea, decreased appetite, mild fever, mild RUQ pain
** later signs include jaundice, dark urine
Discuss Hep A. characteristics.
*highly contagious, single stranded RNA *spread fecal-oral incubation is 14-28 days *usually mild, most people don't know they have
What is the clinical presentation of Hep A?
- fever -malaise -decrease appetite -abdominal discomfort
What are the risk factors for Hep A?
-poor sanitation -lack of clean water -injecting drugs -health care workers -sex partners -living in house with infected person -not vaccinated
What labs do you order for Hep A?
-CBC -LFT -CMP -Hepatitis panel--> if pt has + then: ---IgM, IgG for specific A
Treatment and prevention for Hep A
-support -avoid meds that are hepatotoxic (acetaminophen) -avoid ETOH -safe drinking water -proper sewage disposal -hand washing -immunize
Discuss Hep B characteristics
--double stranded virus -transmitted by infected blood/serum -sex
How is Hep B transmitted
-blood, bodily fluids -sharing needles -mom to infant RISK FACTOR BEING HEALTH CARE WORKER
What is the clinical presentation of Hep B?
--jaundice, fatigue/malaise, N/V
Treatment and prevention for hep B
-treatment aimed at controlling virus and preventing damage to liver -antivirals (benefit most people) -reg blood tests prevention = vaccine
Hep C characteristics
-most common cause of chronic hepatitis, cirrhosis and liver cancer --single stranded RNA (2-26wks for incubation) -no vaccine
Transmission of Hep C.
-IV drug use -high risk sex -reuse of unsterile medical equiptment (NOT SPREAD BY BREAST MILK, KISSING, HUGGING OR BEING AROUND INFECTED PERSON)
Clinical presentation of Hep C
-fever -fatigue -n/v -abd pain, dark urine -80% don't show sx and those listed above are acute
What are tests for Hep c?
1st serological test 2nd nucleic acid test
Treatment and prevention for hep c?
-treatment (not all require) -cure with: interferon and ribavirin, direct antiviral agents (DAA)are better tolerated 12 weeks but expensive -prevent by condoms, safe sharp handling, testing donated blood, hand hygiene
retrovirus attacking CD4
Transmission of HIV
-sex (semen, vag secretions) -IV drug use -mothers to infants
Risk factors for HIV
-unprotected anal or vaginal sed -IV drug use -accidental needle sticks among health care providers
Presentation of HIV
-Acute: fever, HA, rash, sore throat -Later: swollen lymphnodes, weight loss, cough, carps sarcoma, meningitis, TB, lymphomas
Diagnosis of HIV
-enzyme immuno assay -western blot -pcr 5 cs: connection, confidential, counsel, correct results, connection
treatment of HIV
Opportunistic infections seen with AIDS
-pneumonia -brain infections (toxoplasmosis) -MAC = widespread infection= fever, weight loss -yeast inf. of esophagous -histoplasmosis = fever, couch, anemia -lymphoma -kaposis sarcoma -acute necrotizing ulcerative gingivitis (ANUG)
What do universal precautions apply to?
-blood -bodily fluids -semen -vag secretions -CSF -synovial, pleural, peritoneal, pericardial, amniotic fluids
What do universal precautions NOT apply to ?
-feces -nasal secretions -sputum -sweat -vomitus -urine -saliva -tears
What are other exposure causes (other than needle sticks?)
-trauma (bone fragments, bleeding) -childbirth -improper disposal of instruments -improper universal precautions -skin contact -open wound, chapped non-intact skin -mucous membrane -donated blood -airborne