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42 Cards in this Set

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How do you Prophylax for Hep A?
Administration of gamaglobulin
which lab results should be elevated with Hep B?
AST/ALT
Bilirubin
Alk phos
PT, PTT
For Hep B, which serum marker is detectable 4 weeks after infection and typically disappears at 6 months after active infection.
HBsAg: surface antigen
Which Hep B serum marker Appears shortly after HBsAg disappears from serum and persists indefinitely in patients who have recovered from acute infection
Anti-HBs
which Hep B serum marker is not detectable in the serum
HBcAg: core antigen
The presence of this serum marker in chronic HBV infection signals the onset of the nonreplicative phase
Anti-HBe
what is the most reliable indicator of active viral replication.
HBV DNA
what is a serious complication of chronic hepatitis B
hepatocellular carcinoma
How do you contract Hep C?
Blood Parenteral:

transfusion: 85%
drug abuse: needles
how do you treat Hep C?
The patient is given alpha interferon for the chronic infection 3 x’s/ wk for 6 months
what are inteferons?
cytokines produced by T-cells that limit viral replication
when should you avoid giving interferon/Ribavirin to a pt with Hep C?
if the patient is depressed or has drank alcohol within the last 6 months
what is a side effect of Ribavirin?
causes hemolytic anemia
what is a side effect of interferon?
causes depression
which hepatitis requires HBV for its replication
Hep D
Which Hepatitis is mostly seen in India, Asia, Mexico, Africa, and is fecally transmitted (water-borne)
Hep E
which Hep carries the highest risk to developing into chronic hepatitis?
Hep C, 50%
which hepatitis carries a high risk (95%)for developing a fatty liver which is a reversible process
Alcoholic hepatitis
Hypersplenism can cause what conditions?
Anemia
Leukopenia
Thrombocytopenia
what is hemosiderosis?
iron accumulation in the lungs
how do you treat Acute hepatitis?
Stop alcohol intake
Vitamins- folate/thiamine
Low protein diet, if encephalopathy is present
Benzodiazepine-if alcohol withdrawal
Steroids-used with encephalopathy
what are the S/sx of Wernicke Encephalopathy?
Ataxia
confusion
Ophthalmoplegia
what are the S/sx of Korsakoff Syndrome?
Confabulation
Memory loss
what are the Signs & Symptoms of drug related hepatitis?
FEAR

Fever
Eosinophilia
Arthralgias
Rash
what are some causes of inherited chronic liver disorders?
Wilson’s disease
Hemachromatosis
Alpha 1-antitrypsin deficiency
Reye syndrome
How do you diagnose Wilson's disease?
Made by seeing:
Kayser-Fleischer rings(brown rings around cornea)
neurological, psychiatric, hepatitis, and cirrhosis in a young person
what is hemochromatosis?
excessive absorption of iron; deposits are made in the liver, heart, pancreas, kidney, & skin (bronze diabetes)
how do you diagnose haemochromatosis?
Lethargy(men 40-60 y/o)
Skin hyperpigmentation
Diabetes 30-60% of pt’s
Arthopathy
how do you diagnose Alpha 1-Antitrypsin Deficiency?
liver disease with pulmonary manifestations; usually seen in younger people
what are some symptoms of Reyes Syndrome?
Usually seen in pediatrics

Nausea, vomiting, hyperactivity, confusion, seizures, & coma, Increasing drowsiness, Belly Pains
Name some S/Sx you'd find on the arms with hepatic failure
CLAPS:

Clubbing
Leukonychia
Asterixis
Palmar erythema
Scratch marks
Name some clinical features of hepatic failure
Jaundice
Hypoalbuminemia
Hyperestrogenism which causes:
Testicular atrophy
Gynecomastia
Palmar erythema
Spider angiomas

Hepatorenal Syndrome
Fetor odor
Coagulopathy
what can cause hepatic encephalopathy?
Caused by elevated levels of NH3 (ammonia)
what are the precipitating factors for hepatic encephalopathy?
HEPATICS:

Hemorrhage in GIT/ Hyperkalemia
Excess protein in diet
Paracentesis
Acidosis/Anemia
Trauma
Infection
Colon surgery
Sedatives
what is one way to treat hepatic encephalopathy?
Lactulose 50 ml orally Q 2hrs until diarrhea ensues. Then reduce dosage until there are two stools per day
what are the etiologies of cirrhosis?
necrosis
regenerating nodules
fibrosis
this is a condition induced by thrombotic or nonthrombotic obstruction to hepatic venous outflow
Budd-Chiari syndrome
what are some causes of Hepatic cirrhosis?
HEPATIC:
Hemochromatosis (primary)
Enzyme deficiency (alpha-1-anti-trypsin)
Post hepatic (infection + drug induced)
Alcoholic
Tyrosinosis
Indian childhood (galactosemia)
Cardiac/ Cholestatic (biliary)/ Cancer/ Copper (Wilson's)
what are other more rare causes of cirrhosis?
Alcohol
Hep B
Hep C
what are the most common symptoms of biliary cirrhosis?
fatigue & pruritis
what is a serious complication of cirrhosis
Spontaneous bacterial peritonitis (SBP) (E. coli)
Name the syndromes assoc with congenital hyperbilirubinemia
Gilberts: Defect in glucoronyl transferase; Benign, jaundice in stressful situations; > unconjugated

Crigler-najjar: > conjugated; < glucoronyl transferase; Type 1-severe, Type 2- mild

Dubin Johnson: > conjugated; defect in excretion

Rotor: Similar to Dubin Johnson; defect in storage not excretion