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Hepatitis
hepatitis
49
Medical
Graduate
10/09/2008

Additional Medical Flashcards

 


 

Cards

Term
What is Hepatitis?
Definition

A descriptive term that refers to infection with any of the 6 hepatotrophic viruses.

A, B, C,D, E, & G.

Term
How is Hep A transmitted?
Definition

Fecal-Oral route

Contaminated seafood/water etc..

Term
What is the incubation period of Hep A?
Definition

15-45d (3w average)

Remember Hep A: abrupt onset

Hep B: gradual onset

Hep C: insidious onset.

Term

True or False

A pt with Hep A is infectious for 2-3w in the late infection and early clinical course.

Definition
True.
Term

True or False

ALT/AST is elevated 1-2w presymptoms in Hep A.

Definition
True
Term

Concerning labs for Hep A, explain the difference between:

  • Hep A IgG
  • Hep A IgM
Definition
  • If positive, Hep A IgG shows past infection and lasts indefinately.
  • If positive, Hep A IgM (moment) shows a current infection and can last up to 3-6m before it returns to normal.
Term
What is the adverse relationship that exists in the comorbid states of Hep A & Hep C.
Definition
Hep A while normally the most begign of the 6 hepatitis, becomes an aggrevating factor to Hep C & worsens its outcome when they exist together.
Term
What labs are ordered for the hepatitis pt?
Definition
  • CBC
  • Lytes w/LFTs
  • PT/PTT
  • Viral markers
  • HAV antibody (appears when s/s present 1-8w)
  • Anti HAV IgM (Dx made by this lab)
  • Anti HAV IgG
Term
How is Hep A diagnosed?
Definition
  • Anti HAV IgM
  • it is present when s/s appear
  • becomes negative when IgG pops up
  • Pt will have life long immunity after.
Term
What is the tx for Hep A?
Definition

Prevention:

  • Vaccine (2 inj. 6-12m apart)
  • avoid contaminated food
  • Post exposure: Immune globulin
Term
Is it true that there is no chronic disease state of Hep A?
Definition
Yes.
Term

True or False

Hep B is the only one of the Hepatitis to be considered an STD.

Definition
True.
Term

How is Hep B transmitted?

Definition
  • Sex (semen)
  • Blood
  • Saliva
  • Mucous mem.
  • Mom to fetus
  • Tattoo parlors
Term

True or False

Hep B has a asymptomatic carrier state.

Definition
True.
Term
What is one of the worse clinical courses in Hep B?
Definition

Submassive Hepatic Necrosis

60% fatality rate

Term
What is the Hep B surface antigen?
Definition
lab that is positive in the acute stage of infection.  Usually positive in the 4th-12th week.
Term

True or False

80-90% of the time the Hep B surface antigen will disappear in about 3m.

Definition
True.
Term

True or False

If the Hep B surface antigen is positive after 6m of acute infection, the pt is a carrier.

Definition
True, the Hep B surface antigen usually falls away in about 3m 80-90% of cases.
Term

True or False

The Hep B surface antibody:

  • indicates past infection
  • appears after ABsAG dissappears
  • indicates full recovery
  • provides immunity
Definition
True.
Term

True or False

The Hep B core antibody has two parts:

  1. IgG
  2. IgM
Definition

True

Term

True or False

If the Hep B surface antigen is positive the pt is in a highly infectious state.

Definition
True.
Term
What is the tx for Hep B?
Definition
  • Pegelated Interferon Alpha
  • Epivir
Term
What is the post exposure tx for Hep B?
Definition
  • Hep B panel first. then if needed..........
  • HBIG within 24-72h.
Term
Is the treatment for Hep B dependent on the viral load and ALT levels of the pt?
Definition
Yes.
Term
What is the most important lab in regard to treating hepatitis?
Definition
ALT
Term
In the pt that has hepatitis, what could the absence, decline, or low level of liver enzymes be an indicator of?
Definition
It may indicate that the liver is damaged to the point that it no longer is able to produce enzymes.
Term
What disease state must be present first in order to diagnose Hep D?
Definition

Hep B.

If you vaccinate against Hep B, then you really vaccinate against Hep D.

Term

True or False

We did not test our blood supply for Hep C prior to 1992

Definition

True

 

Term

True or False

HIV & Hep C aggrevate one anothers disease states.

 

Definition
True
Term

True or False

90% of IVDA have Hep C if > 45y.

Definition
True.
Term
What is the #1 reason for Liver Transplant?
Definition
Hep C
Term
What are some risk factors for Hep C infection?
Definition
  • Transfusion before July 1992
  • Injecting or snorting drugs-even once
  • Ear, body piercing
  • Hemodialysis
  • organ transplant
  • Multiple sex partners
  • Health care worker
Term
How does the onset of Hep C differ than that of A or B?
Definition
Much slower, insidious onset.
Term
What are some s/s of Hep C?
Definition
  • may have none, many asymptomatic
  • lethargy  fever  nausea
  • ab pain  jaundice 
  • SKIN RASH AND HEADACHES In HIV population
  • ALT can fluctuate
Term
What do most pts with HIV die of today?
Definition
Bleeding complications related to Hep C. If they do not have Hep C, they may live a long life.
Term

True or False

Liver biopsy is the gold standard for amount of liver damage in hepatitis C, but has risk of bleeding & small risk of death.

Definition
True
Term

True or False

Serial levels of HCV-RNA are crucial in management of Hep C.

Definition
True
Term
What is true about HCV-RNA?
Definition
  • Sucessfully treated pts loose HCV-RNA during tx.
  • If HCV-RNA is zero after 6m after tx, cure is durable
  • Cured pts have been followed up to 13y with no return of HCV-RNA
Term

What population should not be treated for Hep C?

Definition

Depressed----suicide

Severe heart disease

Autoimmune diseases

Term

True or false

Regarding the tx of Hep C: Interferon is a protein the body makes to fight viral infections. It protects healthy cells & increases immune response.

Definition
True.
Term

True or False

Treatment of Hep C is sucessful when no Hep C antibody and no vial load exist.

Definition
True.
Term

True or False

In treating Hep C, if HCV-RNA blood levels fall with the first dose of interferon and is zero by one month of tx the pt is curable.

Definition
True
Term
What annual labs should be ordered for chronic Hep C pt?
Definition
  • CT liver (or u/s)
  • LFTs
  • PT/PTT
  • Hep C viral load
  • Alpha Feto Protien
Term
When a pt with HepC is tx with interferon what are the S/E?
Definition
  • Flulike symptoms
  • NO TYLENOL/NSAIDS/ETOH
  • medicate for discomfort with oxycodone
  • beware of suicide attempts
  • causes fatigue and sleep disturbance.
Term
Regarding Hep C, Is it true that Ribavirin is an antiviral drug which cannot eleliminate HCV by itself but when combined with interferon it doubles its efficacy?
Definition
Yes
Term

Evalute the following Hep B panel results & explain its meaning to the pt.:

  • Hep B Surface Antigen: Negative
  • Hep B Surface Antibody: Positive
  • Hep B Core Antibody:  Negative
Definition
  1. No acute disease
  2. Immunity exists due to vaccination
  3. No evidence of past exposure/infection.
Term
What are some S/E of Ribravirin?
Definition
  • ANEMIA TO THE POINT OF DEATH
  • cough
  • SOB
  • Rash
  • dry skin
Term

True or False

In treating Hep C, using the cobonation of Ribavirin and Interferon results in twice the effeciveness.

 

Definition
True, but ribavirin cannot be used alone.
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