chapter 20, hepatitis

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  1. inflammation of liver
    viral hepatitis
  2. how do the cells damage the liver in hepatitis
    • direct from virus
    • cell mediated response to virus
  3. what happens after cell injury occurs in the liver
    • inflammation and necrosis
    • biliary stasis develops
    • bile backs up into blood
    • hepatocytes regenerate, or form fibrious scar tissue(obstructs blood vessels or bile ducts)
  4. what causes Hep A
    RNA virus
  5. how is Hep A transmitted
    • feces
    • fecal-oral
    • sexual transmission(not STD)
    • Highly contagious
    • common in underdeveloped countries
  6. least serious form of hepatitis
  7. what is the incubation period for Hep A
    2-6 Weeks
  8. when is Hep A most contagious
    10-14 days before symptoms during fecal shedding
  9. what causes Hep B
    DNA double strand virus
  10. which Hepititis is species specific to humans and primates
    Hep B(serum hep)
  11. what is the whole viron for Hep B refered to as
    dane particle
  12. Describe the virus that causes Hep B
    • 2 core antigens(HBcAg & HBeAg)
    • 1 surface antigen(HBsAg/australia antigen)
  13. how is Hep B transmitted
    • percutaneous and premucosal exposure to body fluid
    • STD
    • Fomites
    • unsanitary conditions
  14. how long can the Hep B virus survive on enviormental surfaces
    7 days
  15. Who is at risk for Hep B
    • health care workers
    • IV drug users
    • homosexuals
    • infants of infected moms
    • dialysis patients
  16. what is the incubation period for Hep B
    2-6 months
  17. all people with what surface antigen(produced in excess by hepatocytes) are potentially infectious for Hep B
    HBsAg/australian antigen
  18. how soon after exposure can HBsAg appear
    2 weeks
  19. What causes Hep C
    double stranded RNA virus
  20. describe the virus that causes Hep C
    • 6 genotypes
    • over 50subtypes
    • 20% of viral hep
    • genotype 1 common in US
  21. Which age group is more likely to get Hep C
  22. how is Hep C transmitted
    • blood and body fluids
    • infants of infected mothers
    • parenteral route(sharing needles)
    • dialysis patients
    • sex
  23. how severe is Hep C
  24. what is the incubation period of Hep C
    • 2weeks- 6 months
    • 6-9 weeks average
  25. what are the stages of Hepatitis
    • preicteric
    • icteric
    • posticteric
  26. What are the signs and symptoms during the preicteric stage(prodromal) of Hepatitis
    • fatigue& maliase
    • anorexia, nausea& vomiting
    • changes in smell & taste
    • elevated liver enzymes
  27. what causes liver enzymes to be elevated
    released from necrotic hepatocytes
  28. What are the signs and symptoms of the icteric stage of Hepatitis
    • bilirubin increases causing;
    • jaundice
    • clay stools
    • dark urine
    • hepatomegaly
  29. in which Hepatitis is the icteric stage longest
    Hep B
  30. What happens during the posticteric stage of Hepatitis
  31. what diagnostic test are used for Hepatitis
    • H&P
    • urinalysis for bilirubin
    • serum levels of liver enzymes
    • bilirubin serum levels
  32. what are the serum markers for Hep A
    • anti-HAV IgM
    • anti-HAV IgG
  33. in Hep A which antibodiy in the blood indicates lifetime immunity
    anti-HAV IgG
  34. what are the serum markers for Hep B
    HBsAg/australian antigen
  35. If you recover from Hep B will you have surface antigens
    only if you are a chronic carrier and infectious
  36. what are the serum markers for Hep C
    anti-HCV, RNA, PCR(polymerse chain reaction)
  37. what are complications of Hep A
    • never goes to chronic Hep or cirrhosis
    • fuliminating form causing hepatic failure rare
    • never carriers
  38. what are the complications of Hep B
    • carrier state
    • fulminant hepatitis=liver failure=25-90% mortality
    • asymptomatic
  39. what are the complication of Hep C
    • Cirrhosis5-20 deaths out of 100
    • chronic infection=1-5 deaths out of 100
    • chronic liver disease= 60-70 out of 100
    • carrier
  40. In which cases of Hepatitis can chronic active Hepatitis occur
    B & C, progresses to cirrhosis
  41. what types of Hepatitis can develop liver cell carcinoma
    • B & C
    • rare, late complication
  42. what is the treatment for Hepatitis
    • pallative
    • no specific treatment
    • alpha interferon for chronic Hep B & C
    • liver transplants
  43. what are preventative measures for Hepatitis
    • Immunoglobulins
    • Vaccines
  44. what immunoglobulin is given to Hep A patients
    ISG/Immune Serum Globulin
  45. what immunoglobulin is given to Hep B patients
    HBIG/Hepatitis Immune Globulin
  46. which Hepatitis is not effected post-exposure prophylaxis by immunoglobulins
    Hep C
  47. Which Hepatitis has vaccines available
    A & B
  48. Who is the Hep A vaccine recommended for
  49. who is the Hep B vaccine recommended for
    health care workers
  50. what are you recieving when you get a Hep B vaccine
    • Spikes HBsAg
    • very safe
    • genetically engineered
  51. How is recombivax HB/Hepatavax B given
    • 3 IM doses
    • 0-1-6
  52. what are the prognosis for the different types of Hep
    • A=good
    • B=most recover, more severe
    • C=15-25% recover, most develop chronic HCV Infection
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chapter 20, hepatitis
chapter 20, hepatitis
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