Hepatitis

Question 1

hepatitis

Answer 1

Systemic virus that affects the liver
Inflammation of the liver

Question 2

what are the types of hepatitis?

Answer 2

A, B, C

Question 3

Which types of the most common?

Answer 3

B, C

Question 4

Pathogenesis of hepatitis

Answer 4

viral infection
Immune response – inflammatory mediators
Lysis of infected cells
Edema/swelling of tissue
Tissue hypoxia
hepatocyte death

Question 5

s/sx hepatitis

Answer 5

many cases are asymptomatic

Causes abnormal increased LFTs, but not consistent with cell damage within liver

Question 6

Prodromal phase

Answer 6

two weeks after exposure

fatigue, anorexia, malaise, N/V, headache, hyper algesia, cough, low-grade fever

Question 7

T/F the prodromal phase is highly transmissible

Answer 7

True

Question 8

icteric phase

Answer 8

begins with jaundice
2 to 6 weeks, active phase

Dark urine, clay, colored stool, enlarged liver, painful to palpate, fatigue, abdominal pain, persists

Question 9

Which phase is considered the active phase of hepatitis?

Answer 9

Icteric

Question 10

Recovery phase

Answer 10

resolution of jaundice
6 to 8 weeks after exposure, symptoms decrease

Enlarged liver/tender

Question 11

complications of hepatitis

Answer 11

higher mortality in elderly and comorbidities
Chronic hepatitis
Liver cirrhosis
Liver cancer
Fulminate viral hepatitis – acute liver failure

Question 12

hepatitis A transmission

Answer 12

Fecal – oral, IV , sexual
Foodborne illness, poor sanitation

Question 13

s/sx hepatitis A

Answer 13

Acute onset, fever, mild severity

fatigue, fever
N/V/D, pale poop
Stomach pain, no appetite
Dark urine, jaundice

Question 14

Can hepatitis A develop into chronic hepatitis?

Answer 14

no

Question 15

Prevention of hepatitis A

Answer 15

hand hygiene
Vaccine – high risk exposure

Question 16

hepatitis B transmission

Answer 16

IV. Drug use, sexual

Question 17

is hepatitis B, a acute or insidious onset?

Answer 17

Insidious onset, long incubation Period

Question 18

prevention of hepatitis B

Answer 18

Vaccine
Safe sex
Hygiene

Question 19

hepatitis C transmission

Answer 19

IV. Drug use, sexual, mother fetal

Question 20

T/F hepatitis C is an acute onset

Answer 20

False, insidious onset

Question 21

can hepatitis C become chronic

Answer 21

Yes, leads to hepatocellular carcinoma

Question 22

prevention of hepatitis C

Answer 22

Screening blood, hygiene

Question 23

T/F there is no vaccine for hepatitis C

Answer 23

True

Question 24

Hep A vaccine series

Answer 24

two doses, six months apart

All children over one year, high-risk populations

Question 25

hep B vaccine series

Answer 25

Three doses, four months apart All infants beginning as newborns

Question 26

what are disadvantages of hepatitis treatment?

Answer 26

Prolonged therapy Cost Lots of side effects High relapse

Question 27

Direct acting antiviral therapy

Answer 27

Drug therapy for chronic hepatitis C

Question 28

what is the max Tylenol dosage for chronic hepatitis patients?

Answer 28

2 g per day

Question 29

Cirrhosis

Answer 29

scarring of liver, fibrotic liver disease

Question 30

T/F cirrhosis is reversible

Answer 30

False it is irreversible

Question 31

Patho of cirrhosis

Answer 31

not well understood Structural changes from injury – alcohol/viruses and fibrosis

Question 32

Patho of chronic fibrosis

Answer 32

Obstructive biliary channels and blood flow – jaundice, portal HTN Regeneration interrupted by hypoxia, necrosis, atrophy, and liver failure

Question 33

fibrosis

Answer 33

Infiltration of WBC – leukocytes Release, inflammatory mediators in response to fibrotic process

Question 34

How long does cirrhosis occur?

Answer 34

Slowly over years

Question 35

Causes of fibrosis

Answer 35

Alcohol/metabolites – rate depends on amount present

Question 36

can the removal of toxins reverse fibrosis?

Answer 36

No, but it can slow the progression

Question 37

causes of cirrhosis

Answer 37

Hepatitis B and C Excessive alcohol intake Idiopathic **

Question 38

How does alcoholism affect liver disease?

Answer 38

Inhibits exports from the liver, alterations in metabolism of vitamins and minerals and induces mount nutrition

Question 39

what is the most common type of cirrhosis?

Answer 39

Alcohol cirrhosis

Question 40

alcohol fatty liver

Answer 40

Fatty deposits cause lipogenesis Reversible mild, asymptomatic

Question 41

alcoholic streatohepatisis

Answer 41

Precursor to cirrhosis Inflammation/degeneration of hepatocytes Becomes irreversible Anorexia, jaundice

Question 42

alcoholic cirrhosis

Answer 42

Fibrosis in scarring altering liver structure Irreversible

Question 43

T/F alcoholic streatohepatitis is reversible

Answer 43

False

Question 44

pathogenesis of liver disease

Answer 44

Liver cells destroyed Cells try to regenerate Disorganized process Abnormal growth Poor blood flow/scar tissue Hypoxia Liver failure

Question 45

stages of liver damage

Answer 45

Healthy liver Fatty liver Liver fibrosis Cirrhosis

Question 46

s/sx liver disease

Answer 46

G.I. disturbances– N/V, anorexia, gas, change in bowel habits Fever, weight, loss, palpable liver

Question 47

late s/sx of liver disease

Answer 47

jaundice, peripheral edema Endocrine problems Hematologic problem- anemia, bleeding Decreased albumin and protein ascites, skin lesions– spider Encephalopathy Esophageal and Anorectal varices

Question 48

portal HTN

Answer 48

Resistant portal blood flow – varices and ascites

Question 49

causes of portal HTN

Answer 49

systemic hypotension Vascular underfilling Stimulation of RAAS system Plasma volume expansion Increase cardiac output

Question 50

What causes portal HTN to go from asymptomatic to symptomatic?

Answer 50

complications variceal hemorrhage, ascites, hepatorenal syndrome, cardiomyopathy, peritonitis

Question 51

Treatment for portal HTN

Answer 51

Liver transplant

Question 52

what is the primary driver to diagnose hepatic encephalopathy?

Answer 52

Level of consciousness

Question 53

what determines the severity of hepatic encephalopathy?

Answer 53

The grade – minimal, one, two, three, four

Question 54

T/F ammonia levels correlate with hepatic encephalopathy

Answer 54

True, toxins build up in the brain

Question 55

Cause of fulminant/acute liver failure

Answer 55

Most common– acetaminophen overdose

Question 56

T/F acute liver failure is caused by cirrhosis and fibrosis

Answer 56

False, it is not

Question 57

Patho of acute liver failure

Answer 57

edematous hepatocytes and patchy areas of necrosis Inflammatory cell infiltrates and disrupts liver tissue

Question 58

treatment for acute liver failure

Answer 58

Liver transplant

Question 59

when does acute liver failure occur?

Answer 59

6-8 weeks after viral, hepatitis/metabolic liver disease 5 days to 8 weeks after overdose

Question 60

How can the acetaminophen overdose be treated?

Answer 60

Acetylcysteine