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hepatitis
pn 141 test 3 book burke pg 476
| Question | Answer |
|---|---|
| what is it | inflammation of the liver |
| cause of it | virus, alcohol, toxins, gullbladder disease |
| what are the two forms | acute or chronic |
| what is a possible concequence of it | cirrhosis |
| function: what does it metabolise and eliminate | bilirubin, carbs, proteins, fats, drugs and alcohol |
| what is bilirubin | a breakdown product of hemoglobin |
| manis depend on what | the degree of liver damage and the clients health status |
| viral hepatitis: how many viruses can cause it | 6 different ones |
| viral hepatitis:: what are the types | a, B, C, hepatitis delta virus, hepatitis E |
| viral hepatitis: what are the most common ones | A and B |
| viral hepatitis: what do the infections do to the liver | liver cell injury and necrosis |
| viral hepatitis: cause of liver cell damage | the virus or as a result of the body's immune response to teh virus |
| viral hepatitis: are the manis the same for all types | yes |
| viral- A: where does it frequenlty occur | in crowded unsanitary living conditions, contaminated food water and shell fish |
| viral- hep A: incubation | 2-6 weeks |
| viral- hep A: onset | abrupt |
| viral- hep A: transmission | fecal, oral |
| viral- hep A: communicable | 1 week b4 onset, minimal after onset of jaundice |
| viral- hep A: carrier state | no |
| viral- hep A: possible complications | are rare |
| viral- hep A: lab findings | anti-HAV antibodies |
| viral- hep A: prevention | hep A vaccine |
| viral- hep A: prophylaxis | standard immune globulin b4 or w/in 2 weeks or exposeure |
| viral- hep B: onset | slow |
| viral- hep b: incubation | 8-24 weeks |
| viral- hep b: transmission | blood or body fluids, perinatal (transfusion, contaminated needle, sexual contact, mother to fetus, can tranfer disease while having no other s/s |
| viral- hep b: communicable | 1-2 months before s/s, when HBsAg is in the blood |
| viral- hep b: carrier state | yes |
| viral- hep b: possible complications | chronic hepatitis, cirrhosis, liver cancer (risk for cancer big) |
| viral- hep b: lab findings | positive HBsAg, anti HBV antibodies |
| viral- hep b: prevention | hep B vaccine (HBV) |
| viral- hep b: prophylaxis | hep B immune globulin w/ in 1-2 days of exposure, |
| viral: health care workes are at an increased risk for what type | hep B |
| viral- hep c: onset | slow |
| viral- hep c: incubation | 5-12 weeks |
| viral- hep c: transmission | blood and body fluids (contaminated needles) |
| viral- hep c: communicable | when HCV is present in blood |
| viral- hep c: carrier state | yes |
| viral- hep c: possible complications | chronic hepetisis, cirrhosis, liver cancer |
| viral- hep c: lab findings | anti-HCV antibodies |
| viral- hep c: prevention | none |
| viral- hep c: prophylaxis | none |
| viral- hep d: onset | abrupt |
| viral- hep d: incubation | 3-13 weeks |
| viral- hep d: transmission | blood and body fluids, possible perinatal |
| viral- hep d: communicable | when HDVAg is present in the blood |
| viral- hep d: carrier state | yes |
| viral- hep d: possible complications | chronic hepatitis, cirrhosis. fulminant hepatitis |
| viral- hep d: lab findings | postive HDVAg early, anti-HDV antibodies later |
| viral- hep d: prevention | HBV vaccine |
| viral- hep d: prophylaxis | hep B prophylaxis |
| hep d is aka | HDV or delta hepatitis |
| viral- hep E: onset | abrupt |
| viral- hep e: incubation | 3-6 weeks |
| viral- hep e: transmission | fecal, oral |
| viral- hep e: communicable | rarely spread person to person |
| viral- hep e: carrier state | yes |
| viral- hep e: possible complications | many be severe in pregnant wm |
| viral- hep e: lab findings | anti-HEV antibodies |
| viral- hep e: prevention | none |
| viral- hep e: prophylaxis | none |
| viral- hep c: who does it affect | men, AA, and mexicans |
| viral- hep c: most common reason for what | liver transplant |
| viral- hep D: this causes infection only in whom | ppl who have hep B |
| viral hep: what one is rare in US | Hep E |
| viral- hep E: where in the world does it occur | SE asia, africa, central america |
| viral- hep E: who does it affect | young adults, preg wm |
| chronic Hep: what is it | a chronic infection of the liver |
| chronic Hep: what can it lead to | cirrhosis, liver cancer, liver failure, liver trnasplant |
| chronic Hep: what viral infections does it develop from | HBV, HCV, HDV |
| chronic Hep: manis | mild and nonspecific, general malaise and fatiuge and enlarged liver |
| non infectious hep: alcoholic hep- what is it | an acute or chronic inflammation of the liver caused by alcohol |
| non infectious hep: alcoholic hep- is it reversable | yes |
| non infectious hep: alcoholic hep- what can it lead to | necrosis of liver cells |
| non infectious hep: alcoholic hep- it is the most common risk factor for what | cirrhosis in the US |
| non infectious hep: what else can damage the liver | acetaminophne, tetracyclines, poisonous mushrooms, heavy metals, carbon tetrachloride |
| non infectious hep: what can cholelithiasis do; what is the name for it | it interrupts the normal bile flow and blackage of the bile ducts , can lead to inflam of the liver ; hepatobiliary hepatitis |
| manis: what do they range from | asymptomatic to rapidly fatal disease |
| what are the three phases of acute viral hep | 1) preicteric/ prodromal phase, 2) icteric phase 3) psaticteric/ convalescent phase |
| three phases of acute viral: what is the preicteric/ prodromal phase | an abrupt or insidious onset, before jaundice |
| three phases of acute viral: what is the icteric phase | the jaundice phase, the disease develops 5-10 days,early mains may worsen when jaundice develops then imporve |
| three phases of acute viral: what is the psaticteric/ convalescent phase | characterized by an increasing sense of well-being, return of appetite and disapearance of jaundice |
| when does jaundice occur | when serum bilirubin levels are high, causing the skin, MM, and sclera of the eyes to appear yellow |
| three phases of acute viral: what are the s/s of the preicteric/ prodromal phase | fluelike s/s, malaise, fatigue, HA, muscle aches, nasal discharge, sore throat, N/V, diarrhea, constipation, joint pain, constant RUQ pain |
| three phases of acute viral: what are the s/s of the icteric phase | jaundice, pruritis, clay-coloered stools, dark urine |
| three phases of acute viral: what are the s/s of the posticteric/ convalescent phase | well being imporves, energy increases, jaundice resolves |
| is the a specific Tx for jaundice | no |
| diagnostic tests: why is blood drawn | to assess for viral antigens or antibodies to the vrial agent that caused hepatitis |
| diagnostic tests: why is a liver functions test done | serum lvels of these enzymes will be increased if liver is inflamed or damged |
| diagnostic tests: why is serum bilirubin measured | total bili is usually elevated |
| diagnostic tests: why is prthrombin time measured | it may be prolonged if the liver is not able to manufacture protein needed for blood coagulation |
| prevention: what for hep A | vaccines and immune globulin injections |
| prevention: who should be vaccinated | ppl at risk for sexual transmission, injection drug usuers, male prison inmate, ppl of hemodialysis, health care workes, pacific islands, international travelers, recipients of certain blood products |
| tx: for viral | none, get adaqueate rest maintain nutrition avoid strenuous activity, alcohol |
| what are infectious types | hep A,B,C |
| what are the noninfectious type s | ETOH, nonalcoholic fatty liver disease |
| hep A: can you get it again if you already had it | no |
| HEpA: cause | fecal oral so not washing hands and contaminated H2o |
| hep A: is there a vaccine | yes |
| hep A: are the s/s mild or severe | mild |
| hep B: are most ppl acute or chronic | acute (they revover) |
| hep C: are most ppl acute or chronic | chronic they always are contagious |
| hep c: is there a vaccine | no |
| is the liver destroyed slowly or quickly | slowly |
| tx: what viral infection gets antivirals | hep b |
| Hep B&C: when is it chronic | if s/s last for more than six months and body is unable to create antibodies to overcome the viral infection |
| how much tylenol should be given in a day | 4 grams |
| what is the anaogy "if the liver were like the heart it is like right sided heart failure | in liver failure, when the liver cannot do its functions anymore and detoxify the blood from the portal vein gets backs up into the sytems like Rsided ht failure |
| what are functions of the liver | produces bile, digests fat, iflters and detoxes blood, synthesizes clotting factos , breaks down old RBC meds and ETOH, stores BG for energy, breaks down protein |
| functions of the liver/ what happens if it is not functioning right: what happens with no bile profuctions | body unable to digest fats |
| if the body is unable to digest fats waht will stools look like | grey |
| functions of the liver/ what happens if it is not functioning right: what if there is no BG storage | pt will have low BG if not diabetic, possibly normal if they are, it really depends |
| functions of the liver/ what happens if it is not functioning right: what if there is no synthesis of clotting factors | they can bleed and it could cause anemia |
| functions of the liver/ what happens if it is not functioning right: what if it can't break down protein | amonia levels will rise and pt could be confused |
| is toxic hep non infectious or infectious | noninfectious |
| what is the name for the time before the prodromal phase | it is the incubation period; pt has come into contact but body has not detected it yet this is when virus is replicating, asymptomatic |
| what phase does hep a stop at | the prodormal preiictal phase |
| where is the pain | in the RUQ |
| in the prodromal phase pt may think the hep is actually what | just a GI bug |
| at what phase is pt highly contagious ; why | the prodromal phase; b/c the viral load is at its highest |
| icteric phase: what may what may the urine look like; the stool | dark, pale |
| three phases of acute viral: the posticteric/ convalescent phase- how long does improvement take | >6 mo |
| what labs are elevated: | ALT, AST and bilirubin |
| labs: what will PT/INR be, why | high b/c there is no clotting factor |
| what is given to treat PT and INR | vit K |
| meds: why are corticosteroids given | to suppress immune system |
Created by:
jmkettel
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