384729
Descripción
Mapa Mental por greenfylde, actualizado hace más de 1 año
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Creado por greenfylde
hace más de 10 años
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Liver disorders
- Hepatitis
- hep A (RNA virus)
- spread
- fecal oral
- often in travellers/institutions
- fecal oral
- incub
- 2-6w
- 2-6w
- symps/signs
- prodrome: fever, malaise, anorexia, nausea, arthralgia
- jaundice +/- hepatosplenomegaly
- prodrome: fever, malaise, anorexia, nausea, arthralgia
- tests
- serum transaminases rises 3w after exposure
- IgM rises from day 25; IgG remains dectable for life
- serum transaminases rises 3w after exposure
- management
- prevention
- passive immunisation
- human IgG (up to 3mo immun for those at risk (travellers, household contacts)
- human IgG (up to 3mo immun for those at risk (travellers, household contacts)
- active immunisation
- 1 year immunisation; extended to 10y after 6mo booster
- 1 year immunisation; extended to 10y after 6mo booster
- passive immunisation
- treatment
- symptomatic relief
- symptomatic relief
- prevention
- prognosis
- usually self limiting
- fulminant hepatitis occurs rarely; chronic liver disease does not occur
- usually self limiting
- spread
- Hep C (RNA flavivirus)
- spread
- blood; IVDU; sex; acupuncture
- blood; IVDU; sex; acupuncture
- course
- early infect often mild/asymp
- 85% devel chronic infect; 25% devel cirrhosis; a few get hepatocellular cancer
- early infect often mild/asymp
- tests
- LFTs; anti HCV antibodies; HCV-PCR
- Liver biopsy if HCV-PCR +ive to assess liver damage
- LFTs; anti HCV antibodies; HCV-PCR
- management
- interferon alpha + ribavirin in chronic infect
- interferon alpha in acute stage may reduce progresison to chronic disease
- interferon alpha + ribavirin in chronic infect
- spread
- Hep B (DNA virus)
- spread
- Blood products, IVDU, sexual intercourse, direct contact
- Blood products, IVDU, sexual intercourse, direct contact
- risks
- at risk: IVDU + sexual partners; health workers; hemophiliacs;
hemodialysis, sexually promiscuous; close family members of
carriers; staff of long term institutions
- endemic in: far east, africa, mediterranean
- at risk: IVDU + sexual partners; health workers; hemophiliacs;
hemodialysis, sexually promiscuous; close family members of
carriers; staff of long term institutions
- incubation
- 1-6months
- 1-6months
- symps and signs
- resembles hep A
- extra hepatic features are more common
- resembles hep A
- tests
- antigens
- HBsAg
- Surface
- present 1-6 mo after expsoure
- Persistent for 6 months implies carrier status
- present 1-6 mo after expsoure
- Surface
- HBcAg
- Core
- Core
- HBeAg
- DNA material
- Present after acute illness
- Implies high infectivity
- Present after acute illness
- DNA material
- HBsAg
- antibodies
- Abs
- Abs Implies vaccine or previous infection
- Abs Implies vaccine or previous infection
- Abc
- Implies previous infection
- Implies previous infection
- Abs
- antigens
- management
- vaccination
- may be universal or for high risk groups
- passive immunisation may be given following high risk exposure
- Given HBsAg to allow body to produce Abs
- may be universal or for high risk groups
- treatment
- supportive
- avoid alcohol
- supportive
- vaccination
- complics
- Fulminant hepatic failure (rare); relapse; prolonged
cholestasis; chronic hepatitis (10%); cirrhosis;
hepatocellular carcinoma (upto 60 x increased risk)
- Fulminant hepatic failure (rare); relapse; prolonged
cholestasis; chronic hepatitis (10%); cirrhosis;
hepatocellular carcinoma (upto 60 x increased risk)
- spread
- hep A (RNA virus)
- MORE
- http://almostadoctor.co.uk/sites/all/MindMaps/NME/liver1.pdf
- http://almostadoctor.co.uk/sites/all/MindMaps/NME/liver1.pdf
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