Flashcards in Hep Deck (27):
All Hep viruses are RNA except___
Prodrome of Hep
Aversion to smoking
Late stage= enlarged and tender liver + jaundice
What are the lab values in Hep
Replication limited to liver
Shed in feces for 2 wks prior to clinical symptoms
NO CHRONIC HEP A
Dx Hep A
IgM HAV Ab + (IgM anti-HAV)
IgG HAV Ab + (IgG anti-HAV) c (-) IgM HAV Ab = past exposure or immune
Tx Hep A
Transmission: Sex, needle sharing, contact with blood
1st evidence of HBV infection. Acute infection if positive .
Anti-HBs Distant resolved infection or vaccination
IgG=Anti-HBc represents past infection
Increase in viral replication and infectivity, if positive for greater then 3 months=chronic infection
(Anti HBe) Indicated a decrease in viral replication and infectivity
Most specific and most sensitive for early detection indicated active replication in the liver.
Tx for Hep B
Chronic= Alpha interferon, lamivudine, adefovir
When to admit pt with Hep B
encepholopathy, liver failure, unable to maintain hydration
Transmission: Parenteral (IV drugs), hemodialysis, prison, co-infection with HIV 30%
DX Hep C
HCV RNA means active infection.
If HCV RNA is - but Anti-HCV is + then you have a resolved case.
Tx for Hep C
Pegylated interferon for 6-24 months. Ribavirn added if HCV RNA is not cleared after 3 months.
Hep C prognosis
Chronic in 85% of people
30% of chronic get cirrhosis which increases risk for heptocarcinoma
Defective Virus that requires HBC to cause co-infection or superimposed infection.
----faster progression to cirrhosis
feco-oral transmission associated c water
Dx= IgM anti-HEV +
Acute Liver Failure
-Rapid liver failure c encephalopathy and coagulopathy.
What is the most common cause of fulminant hep
Acetaminophen overuse or tox
What dx increases the risk of fulminant hep?
What condition makes it worse?
Due to decreased hepatic production of coagulation factiors
vomiting, coma, AMS, seizures, asterixis (flapping tremor of hand) increase ICP.
Caused by increase in Ammonia levels which is neurotoxic