Term
|
Definition
| inflammation of the liver that can be caused from infections or other causes |
|
|
Term
| What are some things caused by infections? |
|
Definition
| causes include viral hepatitis and infections associated with infectious mononucleosis, secondary syphilis, and tuberculosis |
|
|
Term
| What can noninfectious hepatitis result from? |
|
Definition
| can result from excessive, prolonged use of toxic substances, such as drugs (e.g., acetaminophen, halothane, ketoconazole, methyldopa, and methotrexate) or, more commonly, alcohol |
|
|
Term
| Which hepatitis viruses are viral? |
|
Definition
|
|
Term
| Is chronic viral hepatitis deadly? |
|
Definition
| yes, causes liver cancer and cirrhosis |
|
|
Term
| Are the symptoms of the different hepatitus viruses different? How are the differentiated? |
|
Definition
-all very similar
-differentiated with serologic assays |
|
|
Term
| What are hepatitius A and E? |
|
Definition
-forms of infectious hepatitis
-they are spread by the fecal-oral route
-associated with poor sanitary conditions
-are highly contagious, occur in outbreaks as well as sporadically -cause self-limited hepatitis only |
|
|
Term
| What are hepatitis B, C, and D? |
|
Definition
-forms of serum hepatitis
-spread largely by parenteral routes and less commonly by intimate or sexual exposure
-not highly contagious, but instead occur sporadically, rarely cause outbreaks
-are capable of leading to chronic infection and, ultimately, to cirrhosis and hepatocellular carcinoma |
|
|
Term
| What causes Non A-E? (acute viral hepatitis) |
|
Definition
| the viral etiology is unknown |
|
|
Term
| What causes liver injury in hepatitis? |
|
Definition
| the immune system respose |
|
|
Term
| What is recovery from the hepatitis virus accompanied by? |
|
Definition
|
|
Term
| What is the incubation of viral acute hepatitis? |
|
Definition
|
|
Term
| What is the preicteric phase of illness marked by? |
|
Definition
| the onset of nonspecific symptoms, such as fatigue, nausea, poor appetite, and vague right upper quadrant pain |
|
|
Term
| When are viral titers generally highest? What starts to increase at this point? |
|
Definition
| during the first phase of disease, serum aminotransferase levels start to increase |
|
|
Term
| What determines the icteric phase of illness? |
|
Definition
-onset of dark urine
-jaundice
-fatiue and nausea worsens |
|
|
Term
| If jaundice is severe, stool color BLANK due to pruritus. |
|
Definition
| if jaundice is severe, stool is lighter |
|
|
Term
| What are the serum bilirubin levels like? What are the aminotransferase levels like? |
|
Definition
-Serum bilirubin levels (total and direct) rise
-aminotransferase levels generally are higher than 10 times the upper limit of normal, at least at the onset |
|
|
Term
| What do the levels of hepatitis do as a reult of this? |
|
Definition
| levels lower in liver and serum |
|
|
Term
| how long does clinical illness last? What is recovery first marked by? |
|
Definition
-1-3 weeks
-return of apatite |
|
|
Term
| What are some complications of acute viral hepatitis? |
|
Definition
-Chronic infection
-Fulminant hepatic failure
-Relapsing or cholestatic hepatitis
-Extrahepatic syndromes |
|
|
Term
| Does chronic hepatitis always develop with Hepatitis B and C? |
|
Definition
|
|
Term
| What is the serum sickness seen with acute hepatitis? |
|
Definition
combinations of rash, hives, arthralgias, and fever develops during the preicteric phase
-often attributed to other illnesses |
|
|
Term
| What are used to diagnose viral hepatitis? |
|
Definition
| serologic tests, liver biopsy not recommended |
|
|
Term
| What are some treatments for hepatitis? |
|
Definition
-bed rest
-no alcohol
-no sexual contact |
|
|
Term
| What should all household be given with a case of Hep A? |
|
Definition
| given immune globulin, and initiation of HAV vaccination is appropriate |
|
|
Term
| What should family members get with a case of Hep B? What about sexual contacts? |
|
Definition
| should be vaccinated, and hepatitis B immune globulin (HBIG) also should be given to recent sexual contacts |
|
|
Term
Hepatitis A-
1.Epidemiology
2.Pathophysiology
3.Clinical manifestations
4.Diagnosis
5.Prevention
6.Treatment
7.Prognosis |
|
Definition
1.Epidemiology-fecal oral, contagious
2.Pathophysiology-small RNA virus, Picornaviridae (genus Hapatovirus)
3.Clinical manifestations-incubation 15 to 45 days, jaundice, antibody seen, severe cases in older and ppl with liver disesse
4.Diagnosis-IgM anti-HAV in the serum
5.Prevention-vaccine in 1 or older, reccomended for those at risk
6.Treatment-none, people around infected should get vaccine
7.Prognosis-can persist, but self limiting and cannot progress to chronic illness |
|
|
Term
| Is Testing for total anti-HAV helpful in diagnosis? |
|
Definition
| no, but is can be used to assess immunity in hep A |
|
|
Term
Hepatitis B-
1.Epidemiology
2.Pathophysiology
3.Clinical manifestations
4.Diagnosis
5.Prevention
6.Treatment
7.Prognosis |
|
Definition
1.Epidemiology-the parenteral route or by intimate personal contact
2.Pathophysiology-double-shelled, enveloped DNA virus belonging to the family Hepadnaviridae (genus Orthohepadnavirus)
3.Clinical manifestations-30-150 days incubation, HBV levels fall at onset of symptoms, Anti-HBs is the long lasting immunity
4.Diagnosis-HBsAg in the serum in blood, Testing for IgM anti-HBc because it arises early,can cause fulminant hep
5.Prevention-vaccine for everyone,3 injections, A single dose of HBIG and virus given to exposed person(,14 days) and vaccine for exposure by sex
6.Treatment-interferon alfa and lamivudine for chronic, for acute they should avoid further hepatic injury, and prophylaxis of contacts
7.Prognosis-rarely develops into chronic except in babies and immunocompromised people, chronic commonly leads to cirohis and liver cancer |
|
|
Term
| People who remain HBV DNA or HBeAg positive (or both) at 6 weeks after the onset of symptoms are likely to be developing... |
|
Definition
|
|
Term
Hepatitis C-
1.Epidemiology
2.Pathophysiology
3.Clinical manifestations
4.Diagnosis
5.Prevention
6.Treatment
7.Prognosis |
|
Definition
1.Epidemiology-parenteral(needle drug use most common)
2.Pathophysiology-RNA virus that belongs to the family Flaviviridae (genus Hepacivirus), detectable in serum in titers of 105 to 107 virions/mL during acute and chronic
3.Clinical manifestations-incubation 15-120 days
4.Diagnosis-detection of anti-HCV in serum
5.Prevention-avoid high risk behaviors
6.Treatment-peginterferon alfa and ribavirin(in chronic), acute cases sometimes treated with these because so many end up leading to chronic
7.Prognosis-50-85% of cases become chronic |
|
|
Term
Hepatitis D-
1.Epidemiology
2.Pathophysiology
3.Clinical manifestations
4.Diagnosis
5.Prevention
6.Treatment
7.Prognosis |
|
Definition
1.Epidemiology-linked to hepatitis B, and, consequently, its epidemiology is similar, parenteral and sexual, pts w/blood disorders
2.Pathophysiology-delta virus is a unique RNA virus that requires HBV for replication
3.Clinical manifestations-coinfection (HBV AND HDV) and superinfection (acute HDV with chronic HBV) 4.Diagnosis-superinfection(acute symptoms already diagnosed with chronic HBV), much more common than coinfection
5.Prevention-prevent hep B.
6.Treatment-Most cases of acute coinfection resolve
7.Prognosis- likely to lead to fulminant hepatitis, chronic hep, and cirrhosis |
|
|
Term
Hepatitis E-
1.Epidemiology
2.Pathophysiology
3.Clinical manifestations
4.Diagnosis
5.Prevention
6.Treatment
7.Prognosis |
|
Definition
1.Epidemiology-responsible for epidemic and endemic forms of non-A, non-B hepatitis that occur in less-developed areas of the world, fecal-oral and through water
2.Pathophysiology-HEV is a small, nonenveloped, single-stranded RNA virus that is currently unclassified
3.Clinical manifestations-clinical course of hepatitis E resembles that of other forms of hepatitis
4.Diagnosis-Detection of anti-HEV, particularly of the IgM subclass, is sufficient to make the diagnosis
5.Prevention-There are no known means of prevention or treatment of hepatitis E
6.Treatment-none
7.Prognosis- |
|
|
Term
| What may someone with symptoms of hep be tested for sometimes? |
|
Definition
|
|
Term
| Presence of fever and atypical lymphocytosis points to.. |
|
Definition
|
|
Term
| The presence of hemolysis should suggest... |
|
Definition
|
|
Term
Hepatitis Non A-E
1.Epidemiology and pathobiology
2.Clinical manifestations
3.Diagnosis
4.Treatment
5.Prognosis |
|
Definition
1.Epidemiology and pathobiology-that appear to be viral in etiology but cannot be attributed to any known cause are called hepatitis non-A-E
2.Clinical manifestations-similar to those of recognized forms of acute hepatitis, no clear exposure source
3.Diagnosis-a diagnosis of exclusion
4.Treatment-There is no means of either treatment or prevention of non-A-E hepatitis
5.Prognosis-associated with the complications of acute liver failure and aplastic anemia |
|
|
Term
| Which types of hepatitis have little or no occupational risk? |
|
Definition
| HAV, HEV, and non-A-E hepatitis viruses |
|
|
Term
| Which form of hepatitis is the greatest occupational exposure risk? |
|
Definition
| Hepatitis B virus is most dangerous, hep C is less dangerous |
|
|
Term
| How long can HBV survive in dry blood? |
|
Definition
|
|
Term
| Does the role of saliva in HBV or HCV transmission, except by percutaneous or permucosal routes appear to be significant? |
|
Definition
|
|
Term
| What are some of the complications of hepatitis? |
|
Definition
| Icterus (jaundice), the accumulation of bilirubin in the plasma, epithelium, and urine |
|
|
Term
| What is bilirubin? How is it transported to the liver? |
|
Definition
-a degradation product of hemoglobin and one of the major constituents of bile
-normally is transported to the liver by way of the plasma |
|
|
Term
| What happens t bilirubin in the liver? |
|
Definition
| it conjugates with glucuronic acid, and then it is excreted into the intestine, where it aids in the emulsification of fats and stimulates peristalsis |
|
|
Term
| In the presence of liver disease, bilirubin tends to... |
|
Definition
| accumulate in the plasma as a consequence of decreased liver metabolism and transport |
|
|
Term
| When does jaundice become apparent? |
|
Definition
| when the plasma level of bilirubin approaches 2.5 mg/100 mL |
|
|
Term
| What does it mean if the patient is anicteric? |
|
Definition
|
|
Term
| Most cases of viral hepatitis, especially types A and E... |
|
Definition
| resolve without any complications |
|
|
Term
|
Definition
| can persist and replicate in the liver when the virus is not completely cleared from the organ |
|
|
Term
| What are some potential outcomes of hepatitis? |
|
Definition
-recovery
-persistent infection
-dual infection
-chronic active hepatitis
-fulminant hepatitis
-cirrhosis
-hepatocellular carcinoma
-death |
|
|
Term
| What is Fulminant Hepatitis? |
|
Definition
| A serious complication of acute viral hepatitis |
|
|
Term
| What is fulminant hep characterized by? |
|
Definition
| characterized by massive hepatocellular destruction and a mortality rate of approximately 80% |
|
|
Term
| Who does fulminant hep occur in? |
|
Definition
| occurs more commonly among elderly persons and patients with chronic liver disease |
|
|
Term
| What can cause Fulmiant Hep? |
|
Definition
| Coinfection or superinfection with HBV and HDV, or infection by a single hepatitis virus |
|
|
Term
| What is chronic infection characterized by? |
|
Definition
| by the persistence of low levels of virus in the liver and serum viral antigens (HBsAg, HBeAg, and HCVAg) for longer than 6 months without signs of overt disease |
|
|
Term
| Are patients with chronic infection infectious to others? |
|
Definition
|
|
Term
| The rate of carrier establishment varies depending on... |
|
Definition
| the virus and the age and health of the patient |
|
|
Term
| What is the carrier rate of dentists like? |
|
Definition
3 to 10 times than that of the general population
-highest with hemophilia patients and drug users |
|
|
Term
| What may the carrier state do? |
|
Definition
| -stay the same or progress to chronic active |
|
|
Term
| What can chronic HBV and HCV cause? |
|
Definition
| hepatocellular carcinoma(liver cancer) |
|
|
Term
| After the incubation phase, how many of each virus is asymptomatic? |
|
Definition
10% of hepatitis A
60% to 70% of hepatitis C
70% to 90% of hepatitis B cases are asymptomatic |
|
|
Term
| WHat are many of the signs and symptoms in hepatitis like? |
|
Definition
|
|
Term
| What are the three phases of acute illness? |
|
Definition
1.The prodromal (preicteric) phase- usually precedes the onset of jaundice by 1 or 2 weeks and consists of abdominal pain, anorexia, intermittent nausea, vomiting, fatigue, myalgia, malaise, and fever
2.The icteric phase is heralded by the onset of clinical jaundice, manifested by a yellow-brown cast to the conjunctivae, skin, oral mucosa, and urine
3.Convalescent or recovery (posticteric) phase, symptoms disappear, but hepatomegaly and abnormal liver function values may persist for a variable period |
|
|
Term
| How quickly after jaundice does the sequence of recovery appear? |
|
Definition
|
|
Term
| What are the standard tests in assessing for liver disease? |
|
Definition
| determinations of total and direct bilirubin, albumin, prothrombin time, and the serum enzymes ALT, AST, and alkaline phosphatase |
|
|
Term
| What are the most sensitive markers of acute hepatocellular injury, have been used to identify liver disease since the 1950s? |
|
Definition
| The serum aminotransferases (also called transaminases) |
|
|
Term
| Alkaline phosphatase applies generally to... |
|
Definition
| a group of isoenzymes distributed widely throughout the body |
|
|
Term
| What does Hepatobiliary disease lead to? |
|
Definition
| to increased serum alkaline phosphatase levels through induced synthesis of the enzyme and leakage into the serum, a process mediated by bile acids |
|
|
Term
| The risk of viral hepatitis is reduced by receiving... |
|
Definition
-active immunization
(HABV both have 2) |
|
|
Term
|
Definition
| vaccine available for combination hepatitis A and B |
|
|
Term
|
Definition
| vaccine available for hepatitis B and Haemophilus influenzae type b (in combination with Neisseria meningitidis OMPC) in infants |
|
|
Term
| Harivax and Vaqta are formalin-inactivated whole virus vaccines used specifically to prevent... |
|
Definition
HAV
**safe, works well, reccomended for patients 2 and older** |
|
|
Term
| (Engerix-B and Recombivax B) are produced by recombinant DNA technology |
|
Definition
| 2 vaccines for HBV, 3 vaccines, over 6 month period, produce effective antibody response in most |
|
|
Term
| How long does immunity remain effective? |
|
Definition
| over 10 years, no current booster recommended |
|
|
Term
|
Definition
| people that are exposed to it |
|
|
Term
| Treatment of viral hepatitis can be accomplished by administering... |
|
Definition
| early postexposure immune globulins or postexposure hepatitis B vaccine |
|
|
Term
| Chronic hepatitis BLANK resolves spontaneously. |
|
Definition
| Chronic hepatitis rarely resolves spontaneously. |
|
|
Term
| Who are corticosteriods usually reserved for? Liver transplantation? |
|
Definition
-people with filminant hepatitis
-cirrhosis |
|
|
Term
| All patients with a history of viral hepatitis must be managed as though they are... |
|
Definition
|
|
Term
| Should we treat a patient with active hepatitis? |
|
Definition
|
|
Term
| Any patient who has signs or symptoms suggestive of hepatitis... |
|
Definition
| should not receive elective dental treatment, med con |
|
|
Term
| What should we do if the patient has chronic active hepatitis, however, or is a carrier of HBsAg or HCV and has impaired liver function? |
|
Definition
| the dosage for drugs metabolized by the liver should be decreased, or such drugs avoided if possible |
|
|
Term
| What may someone with liver damage have? |
|
Definition
|
|
Term
| Persons with fulminant hepatitis... |
|
Definition
| should be referred early for possible liver transplantation |
|
|
Term
| What are the long lasting antibodies for Heptitis B? Short? |
|
Definition
|
|
Term
| What is the suggestion for hepatits b injections? |
|
Definition
| 3 injections given in deltoid muscle at 0, 1, and 6 months |
|
|
Term
| What should be given right after an occupational exposure to hepatitis b? |
|
Definition
| HBIG(if exposure is <14 days) and then the vaccines |
|
|
Term
| WHat causes Icterus (jaundice)? |
|
Definition
| the accumulation of bilirubin in the plasma, epithelium, and urine |
|
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