Hepatitis: GeneralDefined as acute or chronic hepatocellular.
- Most common cause of acute hepatitis is viral followed by toxins (*EtOH).
- Most common cause of chronic hepatitis is viral (can also be inherited disorders, autoimmune) |
Viral HepatitisTransmission (A + E) Fecal-oral contamination. Prevent by having a sanitary water supply and hand washing) | Transmission (B + C + D) Parenterally or by mucous membrane contact | Progression to serious liver disease in pts. with chronic Hepatitis C 20-30% progress to serious liver disease, usually if EtOH is involved or pt. also has Hep B or HIV | Clinical Features: general Fatigue, malaise, anorexia, nausea, tea-colored urine, vague abdominal discomfort | When is Hep D found? In conjunction with Hep B, assoc. w/ more severe course | Which infectious are frequently found as co-infections? Hep C + HIV, Hep B + HIV | Lab Findings Elevated aminotransferase levels, bilirubin > 3.0 (=scleral icterus or jaundice), antibodies and antigens present in serology | Treatment: Acute viral hepatitis Supportive (Hep A pts be careful to wash hands/dishes and not share food), avoid EtOG/toxins | All HIV-positive pts. with chronic Hep B should be... Treated for HIV (no matter what the CD4 count is) w/ therapies that cover both infx. | Hep C. patients should also be evaluated for... The level of fibrosis |
| | Toxic HepatitisEtiology EtOH, acetaminophen, isoniazid, halothane, phenytoin, carbon tetrachloride | How to diagnose and treat? Eliminate the suspected agent | What is used for acetaminophen toxicity? Acetylcysteine | Prognosis? Good if the patient survives the acute episode |
CirrhosisDefinition Irreversible fibrosis and nodular regeneration throughout the liver | Etiology EtOH (causes >45% of cases in US), or Hep B/C or congenital disorders | Clinical Presentation Weakness, fatigue, weight loss, N/V, anorexia, amenorrhea, impotence, loss of libido, abdominal pain, hepatomegaly. | Signs/symptoms of late stage cirrhosis Ascites, pleural effusions, peripheral edema, ecchymosis, esophageal varices, and signs of hepatic encephalopathy | Signs of Hepatic Encephalopathy Asterixis, tremor, dysarthria, delirium, coma | Lab Findings Can be normal until late-stage disease. Anemia, mild AST elevation. | Treatment Abstain from EtOH use, salt restriction + bed rest for ascites, can do Spironolactone 100mg qd to diurese. Liver transplant for select patients |
| | Liver Abscess- Caused by Entamoeba histolytica or the coliform bacteria
- Happens after travel or secondary to an intra-abdominal infection.
- Presents with fever and abdominal pain
- Treat with abx, percutaneous drainage, surgical excision |
Liver NeoplasmGeneral Can be malignant (primary or metastatic) or benign | Types of benign neoplasm Cavernous hemangioma, hepatocellular adenoma, infantile hemangioendothelioma | Liver is a common site for... Metastases from other cancers (esp. lung and breast). But if the primary tumor is silent, manifestations may occur in liver first. | What is associated with primary hepatocellular carcinoma Hep B, Hep C, cirrhosis, aflatoxin B1 exposure (from Aspergillus in foods) | Clinical Characteristics Malaise, weight loss, abdominal swelling, weakness, jaundice, upper abdominal pain. Signs include hepatomegaly, splenomegaly, hepatic bruit, ascites, jaundice, wasting, fever | Lab Findings Elevated a-fetoprotein | Treatment: Benign neoplasms Treat if the tumor size might be in danger of rupturing hepatic capsule | Treatment: Metastatic disease Treat the primary lesion | When may surgical resection be attempted? If the cancer is confined to one lobe and there is no concurrent cirrhosis. Liver transplant might be an option. Poor prognosis overall. |
|
Created By
Metadata
Favourited By
Comments
No comments yet. Add yours below!
Add a Comment
Related Cheat Sheets
More Cheat Sheets by ksellybelly