Hep Flashcards Preview

Urinary Analysis > Hep > Flashcards

Flashcards in Hep Deck (27):
1

All Hep viruses are RNA except___

B=DNA

2

Prodrome of Hep

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

3

What are the lab values in Hep

WBC=normal
ALT-elevated
AST-elevated
Bilirubin-elevated
Alkaline phosphate-elevated

4

Hep 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

Dx Hep A

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

6

Tx Hep A

Self-limiting

7

Hep B

Transmission: Sex, needle sharing, contact with blood

8

HBsAg

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

9

HBsAb

Anti-HBs Distant resolved infection or vaccination

10

HBcAb

IgG=Anti-HBc represents past infection
IgM=Acute infection

11

HBeAg

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

12

HBeAb

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

13

HBV DNA

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

14

Tx for Hep B

Acute=Supportive
Chronic= Alpha interferon, lamivudine, adefovir

15

When to admit pt with Hep B

encepholopathy, liver failure, unable to maintain hydration

16

Hep C

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

17

DX Hep C

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

18

Tx for Hep C

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

19

Hep C prognosis

Chronic in 85% of people
30% of chronic get cirrhosis which increases risk for heptocarcinoma

20

Hep D

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

21

Hep E

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

22

Fulminant Hepatitis

Acute Liver Failure
-Rapid liver failure c encephalopathy and coagulopathy.

23

What is the most common cause of fulminant hep

Acetaminophen overuse or tox

24

What dx increases the risk of fulminant hep?
What condition makes it worse?

DM
Obesity

25

Coagulopathy

Due to decreased hepatic production of coagulation factiors

26

Encephalopathy

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

27

Lab results of fulminant hep

Increased ammonia
increased PT/INR>1.5
Increased LFT
Hypoglycemia