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Medical-Surgical Nursing

What are the different types of viral hepatitis? A, B, C, D, and E
What is hepatitis? Inflammation of the liver
Which types of viral hepatitis can cause chronic liver disease? B, C, and D
What defines chronic liver disease from viral hepatitis? Acute viral replication for more than 6 months
What type of virus is hepatitis A (HAV)? An RNA virus
What is the incubation period of HAV? 15-50 days
What is the mode of transmission of HAV? Fecal-oral
How is HAV diagnosed? By the presence of hepatitis A IgM
What is the target cell of viral hepatitis? Hepatocyte
True or False: After resolution of an acute infection of viral hepatitis, hepatocytes can regenerate. True
True or False: Once infected with HAV, a patient can never become reinfected. True
What is the first organelle damaged in an hepatocyte by viral hepatitis? Endoplasmic reticulum
What is often the first sign of hepatic encephalopathy? Changes in handwriting
What serum bilirubin level can indicate severe liver damage? 20 mg/dL for an extended period of time
What type of virus is hepatitis B (HBV)? A DNA virus
What is the mode of transmission for HBV? Percutaneously or perinatal (most common)
True or False: HAV cannot live outside the human body. False; it can live outside the body, possibly for months
True or False: Most young children with HAV usually don't have jaundice. True
Can the HAV vaccine be given in pregnancy? Yes
What is the incubation period of HBV? 45-180 days
How long can HBV live on a dry surface? 7 days
True or False: HBV is much more infectious than HIV. True, by 50-100x
Which age group is most likely to be affected by chronic HBV? Young children
What is tested for to diagnose HBV infection? HBsAG
Can the HBV vaccine be given in pregnancy? Yes
What type of virus is hepatitis C (HCV)? An RNA virus
What is the incubation period of HCV? 14-180 days
Why is the "baby boomer" generation (born 1945-1965) at an increased risk of HCV?
Do the majority of HCV infections become acute or chronic? Chronic
True or False: There is no vaccine for HCV. True
How is HCV diagnosed? By anti-HCV screening tests 4-10 weeks after infection
What is the delta virus? Hepatitis D (HDV)
What is the incubation of HDV? 2-26 weeks
What type of virus is HDV? Single-stranded RNA
What does HDV require to replicate? Coinfection with HBV
What is the mode of transmission of HDV? Percutaneously
What type of virus is hepatitis E (HEV)? An RNA virus
What is the incubation period of HEV? 15-64 days
What is the mode of transmission of HEV? Fecal-oral route, primarily by contaminated water
Is there a way to test for HEV? Not in the United States
Which sex is more at risk for chronic HBV? Men
What are clinical manifestations of acute liver failure? Encephalopathy, GI bleeding, DIC, fever with leukocytosis, oliguria, ascites, edema, hypotension, hypoglycemia, thrombocytopenia, azotemia, and respiratory failure
What is azotemia? A higher-than-normal level or urea or other nitrogen-containing compounds. Tests: BUN (8-20 mg/dL) and Creatinine (0.7-0.14 mg/dL)
What is the only cure for acute liver failure? Liver transplantation
How many genotypes does HCV have? 6
Which genotype of HCV causes most infections? Genotype 1
Why is viral genotyping done with HCV and HBV infections? The genotype determines the choice and duration of therapy
What drug class is used to treat acute HCV? Direct-acting antivirals (DAAs)
In patients with a bleeding disorder, how can a liver biopsy be obtained? By transjugular liver biopsy
What treatment is best for acute HAV and HBV? Supportive
How do nucleoside and nucleotide analogs act? They inhibit viral replication
Which drugs are nucleoside and nucleotide analogs? Lamivudine (Epivir), adefovir (Hepsera), entecavir (Baraclude), telbivudine (Tyzeka), and tenofovir (Viread)
How is PEGylated interferon (PegIntron, Pegasys) administered? By subQ injection
What should be monitored in pts. undergoing interferon therapy? CBC and LFTs every 4-6 weeks
Which nucleotide analog causes severe birth defects? Ribavirin (Rebetol)
What is the normal range for ALT? 5-30 units/liter (U/L)
What is the normal range for ALP? 50-100 U/L
What is the normal range for AST? 10-40 U/L
Created by: shrewsburysd