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Hepatitis
Medical-Surgical Nursing
Question | Answer |
---|---|
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 |