Hep 2

Home > Preview

The flashcards below were created by user Prittyrick on FreezingBlue Flashcards.


  1. Hep C HCV
    • Quick change artist
    • mutates rapidly, multiple variants
    • difficult to treat, no vaccine
    • transmitted by blood or body fluids
    • major risk- percutaneous exposure
    • incubation period 14-180 days
    • incre risk for cirrhosis and liver cancer
  2. Hep C risk factors
    • health care workers
    • public safety officials
    • *** IV drug users **
    • blood or organ recienpts prior to 1992
    • people on hemodialysis
    • multiple sexual partners
    • tatoos/body piercings
    • 1/3 IDU 18-30 are HCV +
    • 0%70 older/former IDU are HCV +
  3. HCV facts
    • 70% of HCV becomes chronic
    • - chronic HCV can take 20 yrs to develop
    • every 100 individuals infected with HCV
    • - 75-80 chronic infection
    • -60-70 chronic liver disease
    • - 5-20 develop cirrhosis over 20-30 years
    • - 1-5 will die of complications
  4. Hep C
    dx
    • may be asymptomatic for years
    • dx by:
    • detection of RNA virus (HCV RNA) (expensive)
    • Anti HepC antibodies can be detected in 97% within 6m
    • - markers for disease, no protective function
    • - often elev LFT as dx (asymptomatic)
  5. Hep D (HDV)
    • dangerous duo
    • must have HBV to reproduce and only occurs in those with HBV
    • same transmission as HBV
    • endemic to mediterranean region uncommon in the US
    • coinfection with HBV and HDV: more severe acute disease, mmay result in a fatal fulminant hepatitis
    • D can survive on its own
    • if u have D and B damage to the liver incre
  6. Hep E HEV
    • in the water and alot more
    • rarely seen in the US
    • seen: developing countries with inadequate sanitation
    • - reported in Asia, Africa, and Central America, mexico
    • - refugee camps, overcrowded housing, natural disasters
    • contaminated water (fecal-oral route)
    • - fecally contiminated drinking water
    • dx by history and r/o other types of hepatitises
  7. Hep F
    • False
    • does not exist
    • turn out to be variant of HCV
  8. Pt teaching
    • rest
    • diet
    • good hygiene practices
    • avoid ETOH for 6 months
    • avoid known heptotoxic agents
    • follow up care
    • usually screened for other bloodbourne diseases (HIV)
    • international travel to an area with intermediate/high rate: precautions with food/water, vaccine
  9. Nx interventions
    • monitor fluid and electrolyte status- dehydration or overload
    • weight daily
    • - gain/loss >/= 2lbs reportable
    • assess complications: bleeding tendencies, changes in LOC (ammonia levels), chronic hepatitis, liver failure (previous Hx hep + liver disease)
  10. health care professional
    • review brunner: HCP needle stick and recommendations- Brockton Hosp policy needlestick
    • review BH policy: on needlestick and blood/body fluid exposure
  11. Drug Therapy
    HAV
    • HAV
    • - Hep A vaccine- pre-exposure prophylaxis
    • -- best way to prevent HAV infections (CDC)
    • -- recommendations: children at 1, travelers to high risk areas, IDU, persons w/chronic liver disease, other high risk groups CDC
    • -- people who have been exposed to HAV and have not been vaccinated with w/in 2 weeks of exposure
    • Immunity effects occur w/in 1 month (IgG)
    • 95-100 effective
  12. Drug therapy 2
    HAV
    • multidose vaccine combining HAV and HBV protection is available
    • immunoglobulin- b4 and after exposure (w/ Hep A vaccine)
    • - temporary passive immunity effective w/in 2 weeks of exposure for 6-8 weeks
    • preferred: Hep A vaccine
  13. Drug Therapy
    HBV
    • vaccine effective (>90% CDC)
    • reccommended for all healthcare and public safety workers, at birth, children < 18, others at high risk
    • unprotected exposure- vaccine & immunoglobulin within 24 hrs
  14. Drug therapy
    HBV
    • goal is to decrease viral load and decre rate of progression
    • - Alpha interferon (influenza) x 4m= decre viral replication- s/e flu like symptom
    • - nucleoside analog: lamivudine (epivir) for 1 yr. or adeforvir dipivoxil
    • --- decre viral replication inhibit- s/e nephrotoxicity (renal crt)
  15. Drug therapy
    HCV
    • no vaccine for HCV and immunoglobulin does not provide protection
    • no specific
    • triple therapy per CDC (multiple drugs)
    • pegylated interferon, combined with ribavirin (rebetol): tx of choice
    • new research: protease inhibitors (approved 2011)
  16. Drug Therapy
    HDV, HDE. HDG
    • HDV-
    • no vaccine
    • can be prevented in persons who are not not already vaccinated by Hep B vaccine
    • interferon is under research studies
    • HDE-
    • no vaccine
    • no acute treatment
    • HDG
    • no vaccine
  17. Public education
    HBV & HCV
    • universal precaution
    • avoiding recapping or reuse of needles
    • screening of donated blood
    • condom use
    • good handwashing
    • good hygiene
    • vaccination
    • post exposure prophylaxis
  18. psychological support
    • pt may feel fearful, helpless, guilty
    • may lead to depression, risky behavior isolation
    • support groups
    • - hepatitis
    • - behaviors- AA, NA etc
  19. Drug induced hepatitis
    • most common cause acute liver failure
    • path: same as viral hepatitis
    • onset is usually abrupt
    • - s/s chills, fever,rash, pruritus, gi s/s, arthralgia
    • - later: jaundice, dark urine, tender RUQ, hepatomegaly, abn LFT
  20. Drug induced hep 2
    • medications: tylenol, anesthetic agents, methotrexate, methyldopa, statins, thiazides directics
    • tx
    • discontinue the agent
    • short term high dose steriods- to decre inflamm
    • liver transplant (severe)
    • (50% is drug related, it could occur over 24 hrs, or can occur a month later)

Card Set Information

Author:
Prittyrick
ID:
314386
Filename:
Hep 2
Updated:
2016-01-27 01:15:40
Tags:
Hep
Folders:

Description:
Hepatitis C and etc
Show Answers:

Home > Flashcards > Print Preview