Flashcards in Liver Deck (13):
Causes of acute and chronic hepatitis?
Viral infections (Hep. A-E/ Non A-E infections)
Hep B +/- Hep D virus
Metabolic disorders such as Wilson's, alpha- 1-antitrypsin deficiency, haemochromatosis
If you suspect hepatitis, what should you do?
Microbiology viral screen
CLincial chemistry for ferritin, transferrin, lipids, caeruloplasmin, AFP, alpha-1 antitrypsin
Which Heps tend to be clincially grouped together?
A and E
B and D
What is Hep A?
RNA picorna virus
Incubation period of 2-6 weeks
most common world wide
80% asymptomatic and naturally cleared
does not lead to chronic, no carriers
no specific treatment, low mortality
RNA calcivirus, feco-oral transmission
simialr clinically to Hep A, leads to acute epidemics, but no progression, chronic diseae
common in indo-china- thus consider recent travel
alarm bells in pregnant women
Hepa-DNA virus: blood semen, saliva, skins breaks or mucous membranes
Vertical transmission is the most common cause of transmission worldwide
incubation 1-6 mo
virus has an inner core and an outer envelope
around 10% into chronic, 1% fulminant liver disease
incomplete RNA virus, can only cause infection in presense of B
acute or chronic
RNA flavi virus, clincally similar to B
common in IVDUs, body fluids
rare vertical and sexual
85% chronic infection, 30% cirrhosis within 20 yrs
Vaccines for Hep?
A and B, but not C
10-15% cant be typed
What other viruses than Hep A-E can cause acute hep?
CMV, yellow dever, and HSV in immunocompromised
Describe the pathophysiological process of acute hepatitis
hepatocytes swell and undergo vacuolisation before they necrose and are rapidly removed
this is usually maximal in zone 3, as this is centrilobular and thus receives the least oxygenated blood
the extent can vary from scattered necrosis to multiacinal necrosis leading to fulminant hepatic failure
Reminder: which zone most likely to undergo degenerative changes in acute hep?
the centrilobular area: zone 3