Term
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Definition
Think "A" for Acute-no chronic Hep A.
Ingestion of Contaminated Water-Fecal/Oral
More likely to have jaundice as you age
No Chronic Infx
IgM anti-HAV if acutely infected |
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Term
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Definition
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Term
| Acute Hepatitis B Markers |
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Definition
| HBsAG and anti-HBc IgM both positive. Remember "M" in IgM means miserable-first to show up with acute infection. |
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Term
| What to do if mom delivers baby and is Hep B surface AG positive? |
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Definition
| Baby gets HBIG and starts Hep B series in hospital. |
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Term
| Hep B vaccine dosing schedule |
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Definition
3-4 doses
Dose 1 -at birth (monovalent only)
Dose 2 - 4 weeks later (not before 6 weeks if in combo vaccine)
Dose 3 -8 weeks after first dose
Dose 4- Not before 24 weeks. |
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Term
| Which Hepatitis do 75% go on to develope CHRONIC infection? |
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Definition
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Term
| What will serology look like for Prior Immunization of Hep B? |
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Definition
HBsAG is give (not core), BUT
HBsAG will not show positive for immunization due to dose being so small. |
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Term
| What to do if you suspect a false positive anti-HCV? |
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Definition
| Order a RIBA test. If it is negative-then the anti-HCV was a false positive. |
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Term
| What serology marker do you draw to determine level of Hep B viremia? |
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Definition
| HBeAG-it's presence indicates high level of circulating virus. THESE pts are referred for treatment. |
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Term
| What is required for diagnosis of cirrhosis? |
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Definition
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Term
| How is severity of cirrhosis determined? |
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Definition
| clinical parameters determine-not biopsy findings. The Child's-Pugh Criteria are used for this. |
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Term
| What immunizations/vaccines are needed for your cirrhosis patient? |
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Definition
Hep A and B, influenza and pneumococcal,
screen periodically for Hepatocellular carcinoma with AFP level |
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Term
| Patient Education for Cirrhosis |
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Definition
1)Alcohol-avoid
2)Acetaminophen-don't use if patient drinks alcohol. Don't exceed 2 grams in 24 hours with decompensated cirrhosis
**Safe in pts with compensated cirrhosis-no more than 3g/day
**If pt has cirrhosis and ascites-acetaminophin SAFER than NSAIDS
3)Stay AWAY from undercooked/raw seafood-can be lethal in cirrhosis
4)Vit A accumulates in liver-careful with vitamin supplmtns
5)Iron is hepatotoxic- |
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Term
| What medication is used if large varices are seen on endoscopy with cirrhosis? |
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Definition
| non-selective B-blocker-such as propranolol or nadolol |
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Term
| How does cirrhosis affect HTN? |
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Definition
| Cirrhosis causes a systemic vasoDILATION-so often don't need the meds they used to take for HTN |
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Term
| Rx with Diagnosis of Cirrhosis |
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Definition
Child's-Pugh criteria of "c"-reudce by 50% the meds that are metabolized in the liver.
don't restrict protein unless encephalopathy resistant to lactulose develops |
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Term
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Definition
| suspect ischemia or drug toxicity-NOT hepatitis |
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Term
| What time frame constitutes chronic Hep B? |
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Definition
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Term
| Steps to determine Hep B Status: |
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Definition
1)Look at HBsAG-if positive-here is Hep b-go to step 2. If neg-no hepatitis.
2)Acute or Chronic? If HBcAB IgM is positive-then acute. If Neg-then prob. chronic-observe for 6 months.
REMEMBER the "M" in IgM means miserable-shows up first-indicates acute!
3)does pt have measurable amt of virus? Look at HBeAB. If pos-then viremic-refer patient. If neg-low grade and no treatment indicated. |
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Term
| What will immunization against Hep B show? |
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Definition
| Will show ONLY anti-HBsAb ..not anti-HBcAb. People who have been vaccinated-never positive for HBsAG-because amount given in vaccine to small to be detected. |
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Term
| How does Hepatitis C present? |
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Definition
| Usually silent, 85% progress to chronic Hepatitis. |
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Term
| What does the patient have to have in order to be positive for Hepatitis D? |
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Definition
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Term
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Definition
No seriologic test-can use ELISA. Seen in US only in travelers from endemic aras.
Hep E--is like Hep A--in that is ONLY causes ACUTE disease. |
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Term
| Most common cause of cirrhosis |
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Definition
| Hep C--Not alcoholism.. This disease progresses over decades. Hep C-most common cause of Liver CA-and reason for Liver Transplantation |
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Term
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Definition
| 85 percent will get chronic Hepatitis--20 percent of those will get cirrhosis. People who drink alcohol progress these odds. Males progress faster than females. |
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Term
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Definition
| Unlike Hep A and B-whose patients present sick and jaundice--Hep C are primarily asymptomatic. |
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Term
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Definition
IV Drug Use-most common. (even after 2 or 3 times of using drugs)
Transfusions (before 1991)-there was a 10 percent chance of Hep C transmission
Sexual transmission in monogomous couple very low. Higher in people with mult sexual partners.
Intranasal coccaine-30 fold increase in Hep C.
Tattooing-potential risk. |
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Term
| What two types of Hepatitis can become chronic? |
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Definition
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Term
| What is patient shows up sick--and positive for Hep C? |
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Definition
| Hep C doesn't usually make sick--look for other causes. |
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Term
| If RNA test for Hep C is positive? (checks for virus in the blood) |
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Definition
| Definitive for the disease. It's about 250 dollars--very expensive. |
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