Viral Hepatitis And Acetaminophen Hepatotoxicity Flashcards Preview

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Flashcards in Viral Hepatitis And Acetaminophen Hepatotoxicity Deck (20)
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0
Q

Course of hepatitis?

A
  1. Constitutional symptoms, arthralgias, myalgias, pharyngitis
  2. Visible jaundice, enlargement of the liver, dark urine
1
Q

Transaminase levels more than 1000 may lead to? Causes?

A

Extensive hepatic necrosis. Causes: toxic injury, viral hepatitis, ischemia

2
Q

Hepatitis A and E are transmitted by?

A

Fecal oral route. By contaminated food or water and daycare

3
Q

Most common cause of acute viral hepatitis in the US?

A

Hepatitis A

4
Q

Worst-case scenario after hepatitis A infection?

A

A few patients get fulminant disease resulting in liver failure

5
Q

Worst-case scenario after hepatitis E infection?

A

Pregnant women can develop severe hepatic necrosis and fatal liver failure

6
Q

Adult vs Newborns infected with hepatitis B. Chance of chronic infection?

A

5% versus 90%

7
Q

Hepatitis most likely to be sexually-transmitted?

A

B (C to lesser extent)

8
Q

Hepatitis transmitted by blood transfusions or IV drug use?

A

C

9
Q

Fulminant hepatic failure is usually caused by? Prognosis?

A

Hepatitis B and D or drug-induced. Poor prognosis.

10
Q

How to diagnose hepatitis A,B,C?

A

A: Anti-hepatitis A IgM
B: hepatitis B surface antigen
C: hepatitis C RNA assay or anti-hepatitis C antibody

11
Q

Window period?

A

Interval between the disappearance of HBsAg and the appearance of anti-HBsAb

12
Q

Describe hepatitis A vaccine. Efficacy?

A

Two doses given six months apart. Exceeds 90%.

13
Q

Postexposure prophylaxis to contacts of patient with hepatitis A or B?

A

If not vaccinated: Hepatitis A/B immunoglobulin along with the first injection of the vaccine

14
Q

Hepatitis B vaccine: delivery and efficacy?

A

Given in three doses over six months. Over 90%.

15
Q

Hepatitis C immunization and postexposure prophylaxis?

A

None

16
Q

Treatment for patients with chronic hepatitis B? B or C?

A

Lamividine. Interferon

17
Q

Hepatotoxicity by acetaminophen results after acute ingestion of?

A

10 g or more (lower in patients with existing liver disease especially those who abuse alcohol)

18
Q

Acetaminophen metabolism? Neutralization? Increased risk of injury if?

A

Metabolized by P450 enzymes. Produces toxic metabolite which is detoxified by glutathione.

Increasing injury:

  1. P450 induction (from alcohol or phenobarbital)
  2. Decreases in glutathione from alcoholism, malnutrition or AIDS
19
Q

Treatment of acetaminophen toxicity? Mechanism of treatment? Duration of treatment?

A

Decontamination with charcoal and N-acetylcysteine. N-acetylcysteine provide cysteine to replenish glutathione stores. Start within the first 10 hours to prevent liver damage continue for 72 hours.

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