We’ll go through the important causes of viral hepatitis or hepatites.
In general, self-limited acute – A, acute, give yourself an example – viral hepatitis A.
E, we’ll talk about in a little bit.
And then we'll talk about viruses that usually
affect the liver in an acute nature – EBV, CMV, HSV.
Chronic hepatitis, more so dealing with your B, C and D.
Begin by looking at our hepatitis A.
Transmission: feco-oral transmission.
Incubation period, about two to six weeks.
Presents with nausea and vomiting – n/v.
And think about where your liver is,
RUQ, right upper quadrant pain, with jaundice.
Remember that jaundice, mixed picture.
All depends as to how much damage has taken place to liver.
What kind of clues are they going to give you on your board,
so that you know as to – wow, liver might be affected?
AS, ALT transaminases.
In viral, it would be more ALT.
Can cause severe disease in elderly
or patients with pre-existing liver disease.
Does not – I repeat, does not lead to chronic hepatitis,
but can have relapsing course.
A – hepatitis A – you should be thinking A, acute,
not so much chronic.
Diagnosed by anti-HAV IgM antibody.
Prevention of hepatitis A.
Vaccination recommended for travelers to endemic areas.
Military workers. IV drug abusers or IV drug users.
Homosexuals, remember feco-oral is your route.
Patients with chronic liver disease.
And the reason for that, remember, A will not cause chronicity.
However, if there's a pre-existing liver disease,
then hepatitis A will only make it worse
and allow the patient to go into fulminant hepatitis.
Vaccinate, close contact of a case in which
maybe perhaps there is something
with close encounters that might have taken place.
For example, think about prisoners and convicts.
Immunoglobulin useful for passive immunity
for suspected exposure if used within two weeks.
Prevention becomes important here with hepatitis A.
This is where your focus should be, approximately two weeks.