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Flashcards in Hep Deck (27)
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1
Q

All Hep viruses are RNA except___

A

B=DNA

2
Q

Prodrome of Hep

A
Anorexia
N/V
Malaise
URI sx
Aversion to smoking
Late stage= enlarged and tender liver + jaundice
3
Q

What are the lab values in Hep

A
WBC=normal
ALT-elevated
AST-elevated
Bilirubin-elevated
Alkaline phosphate-elevated
4
Q

Hep A

A
Feco-oral transmission 
Incubation time=4wks
Replication limited to liver
Shed in feces for 2 wks prior to clinical symptoms
NO CHRONIC HEP A
5
Q

Dx Hep A

A

IgM HAV Ab + (IgM anti-HAV)

IgG HAV Ab + (IgG anti-HAV) c (-) IgM HAV Ab = past exposure or immune

6
Q

Tx Hep A

A

Self-limiting

7
Q

Hep B

A

Transmission: Sex, needle sharing, contact with blood

8
Q

HBsAg

A

1st evidence of HBV infection. Acute infection if positive .

9
Q

HBsAb

A

Anti-HBs Distant resolved infection or vaccination

10
Q

HBcAb

A

IgG=Anti-HBc represents past infection

IgM=Acute infection

11
Q

HBeAg

A

Increase in viral replication and infectivity, if positive for greater then 3 months=chronic infection

12
Q

HBeAb

A

(Anti HBe) Indicated a decrease in viral replication and infectivity

13
Q

HBV DNA

A

Most specific and most sensitive for early detection indicated active replication in the liver.

14
Q

Tx for Hep B

A

Acute=Supportive

Chronic= Alpha interferon, lamivudine, adefovir

15
Q

When to admit pt with Hep B

A

encepholopathy, liver failure, unable to maintain hydration

16
Q

Hep C

A

Transmission: Parenteral (IV drugs), hemodialysis, prison, co-infection with HIV 30%

17
Q

DX Hep C

A

Anti-HCV +
HCV RNA means active infection.
If HCV RNA is - but Anti-HCV is + then you have a resolved case.

18
Q

Tx for Hep C

A

Pegylated interferon for 6-24 months. Ribavirn added if HCV RNA is not cleared after 3 months.

19
Q

Hep C prognosis

A

Chronic in 85% of people

30% of chronic get cirrhosis which increases risk for heptocarcinoma

20
Q

Hep D

A

Defective Virus that requires HBC to cause co-infection or superimposed infection.
—-faster progression to cirrhosis

21
Q

Hep E

A

feco-oral transmission associated c water
Self-limiting
Dx= IgM anti-HEV +

22
Q

Fulminant Hepatitis

A

Acute Liver Failure

-Rapid liver failure c encephalopathy and coagulopathy.

23
Q

What is the most common cause of fulminant hep

A

Acetaminophen overuse or tox

24
Q

What dx increases the risk of fulminant hep?

What condition makes it worse?

A

DM

Obesity

25
Q

Coagulopathy

A

Due to decreased hepatic production of coagulation factiors

26
Q

Encephalopathy

A

vomiting, coma, AMS, seizures, asterixis (flapping tremor of hand) increase ICP.
Caused by increase in Ammonia levels which is neurotoxic

27
Q

Lab results of fulminant hep

A

Increased ammonia
increased PT/INR>1.5
Increased LFT
Hypoglycemia