|
Transmission (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
|
|
Etiology
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
|
|
Definition
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
|
|
General
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.
|
No comments yet.
Cheatography n. The art of mapping complex subjects into clear, instantly navigable reference guides.
