Wk 4 Hepatitis Flashcards by Diana Hallis

Hep E and D are…

not common in USA

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What are 2 other viruses that can cause hepatitis

Epstein-Barr

Cytomegalovirus

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Hepatitis can have other causes not from a virus such as… (4)

Alcohol abuse
Drugs
Chemicals
Bacteria

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What are the most common strains of viral hepatitis?

B and C

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What type of viral hepatitis is VERY dangerous in pregnancies?

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What is the pathogenesis of viral hepatitis?

Infection which leads to inflammatory mediators that cluster around liver, causing lysis of cells and death, then tissue hypoxia. End result: edema and swelling

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In many cases __ types of viral hepatitis are asymptomatic

ALL

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Viral hepatitis causes elevated __

LFTs

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Viral hepatitis is NOT consistent with…

cellular damage within the liver

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When is the prodromal stage of viral hepatitis?

2 weeks after exposure

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In the prodromal phase, viral hepatitis is __ __.

highly transmissible

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What are the symptoms of the prodromal phase of viral hepatitis?

Fatigue
Anorexia
Malaise 
Nausea
Vomiting
HA
hyperalgesia
cough 
low grade fever

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What is hyperalgesia?

Extreme sensitivity to pain

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When is the icteric phase of viral hepatitis?

Begins with jaundice

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What happens to the liver in the icteric phase of viral hepatitis?

Liver is enlarged and may be painful to palpation

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What are symptoms of the icteric phase of viral hepatitis?

jaundice
dark urine
clay-colored stools
fatigue
abdominal pain

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What is different about the abdominal pain in the icteric phase versus the prodromal phase of viral hepatitis?

It either persists or increases in severity

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After the icteric phase, what can happen to a patient with viral hepatitis?

They can develop chronic hepatitis

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What is the recovery phase of viral hepatitis?

Resolution of jaundice

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When is the recovery phase of viral hepatitis?

6-8 weeks after exposure with diminished symptoms

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What is something important to note about the recovery phase of viral hepatitis?

Liver remains enlarged/tender

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Most patients with acute viral hepatitis…

recover completely with no complications

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What is the overall mortality rate for viral hepatitis?

Less than 1% unless the patient is elderly or has comorbidities

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What are 4 potential complications of viral hepatitis?

Chronic hepatitis
Liver cirrhosis
Liver cancer
Fulminant viral hepatitis - acute liver failure

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Hep A is considered a...

food borne illness related to unclean sanitation and improper handling of food

What is the transmission of hepatitis A?

Mainly fecal-oral

What other ways can hepatitis A be spread?

Parenteral or sexually

What is the severity of hepatitis A?

Usually mild, acute onset

Hepatitis A does NOT lead to what?

chronic hepatitis

What are the symptoms of hepatitis A?

``` fatigue fever n/v/d stomach pain dark pee clay colored stool jaundice ```

Who can get hepatitis A?

Really anyone, children and adults

How do you prevent hepatitis A infection?

Hand hygiene | Hepatitis A vaccine

How is hepatitis B spread?

IV drug use | Sexual contact

What is the onset like of hepatitis B?

insidious

How long is the incubation period of hepatitis B?

60-180 days before they may or may not show symptoms

How many patients who are infected with hepatitis B will develop chronic hepatitis B?

About 10%

Hepatitis be is a severe disease and may have a...

prolonged course

Who can get hepatitis B?

Anyone

What are 3 ways to prevent hepatitis B?

HBV vaccine Safe sex Hygiene

If hepatitis B becomes chronic, what are 2 complications that can happen?

Liver Cancer | Liver failure

What is associated with both liver cancer and liver failure?

cirrhosis of the liver

How is hepatitis C spread?

``` Parenteral Sexual Mother to fetus Medical mistakes Sharing toothbrushes or razors ```

What is the onset like of hepatitis C?

Insidious

What are the severity of the symptoms of hepatitis C?

Mild to severe

What percent of patients with hepatitis C will develop chronic hepatitis?

80%

Who can get hepatitis C?

Anyone

What is important to note about hepatitis C?

There is no vaccine

What are the symptoms of hepatitis C? (4)

No symptoms Stomach pain Vomiting Jaundice

What does hepatitis C not spread through? (2)

Breast feeding | Insect bites

What does hepatitis C lead to? (2)

Hepatocellular carcinoma | Need for liver transplant

How is hepatitis C prevented? (3)

Do not participate in high risk activities Screen blood hygiene

What is the dosing for the hepatitis A vaccine?

2 doses 6 months apart

What is the recommendation for getting the hepatitis A vaccine?

All children beginning at 12 months | Special high risk populations

What is the dosing for the hepatitis B vaccine?

3 doses at least 4 months apart

Who is recommended to get the hepatitis B vaccine?

All infants beginning as newborns

What are the two classes of drugs for chronic hepatitis B?

Interferons | Nucleoside analogs

Why are there 2 classes of drugs we use to treat chronic hepatitis B?

Because the virus has mutated causing certain strains to be resistant to treatments

Treatment for chronic hepatitis B is reserved for those who are...

high-risk patients that are showing liver damage

What are 3 indicators of a high-risk patient in need of hepatitis B treatment?

Elevated AST levels Hepatic inflammation Advanced fibrosis

What are the disadvantages of treating hepatitis B?

Prolonged therapy Costs and adverse effects High relapse

The adverse side effects of chronic hepatitis b drugs are...

Interfere with a lot of drugs patients may take for other conditions tone of side effects

For hepatitis C, who is treatment recommended for?

Only those with chronic disease, but this concept is changing with the introduction of newer drugs

Hepatitis C is NOW...

Easily treatable and eliminated in most all patients

What is chronic hepatitis C treated with?

direct-acting antiviral therapy

What else might you see being added to the regimen for treatment of hepatitis C? (2)

Interferon-based regiments | Nucleoside analogue

Direct-acting antiviral therapy drugs are very expensive but...

Because they work so well they are considered cost beneficial

Can a patient with active/chronic hepatitis take Tylenol?

Yes but it is recommended that they take less than 2g a day

What is the maximum daily recommendation of Tylenol for someone who does not have liver damage?

If someone has advanced liver disease we would want to avoid...

Tylenol and NSAIDs

What is pegylated interferon-alpha is used for what?

Hep B

Ribavirin is used for what?

Hep B

Wk 4 Hepatitis Flashcards

(71 cards)