00:01
Viral hepatitis.
00:02
We’ll go through the important causes of viral hepatitis or hepatites.
00:08
In general, self-limited acute – A, acute, give yourself an example – viral hepatitis A.
00:17
E, we’ll talk about in a little bit.
00:19
And then we'll talk about viruses that usually
affect the liver in an acute nature – EBV, CMV, HSV.
00:28
Chronic hepatitis, more so dealing with your B, C and D.
00:39
Begin by looking at our hepatitis A.
00:42
Acute, A.
00:44
Transmission: feco-oral transmission.
00:47
Incubation period, about two to six weeks.
00:50
Presents with nausea and vomiting – n/v.
00:54
And think about where your liver is,
RUQ, right upper quadrant pain, with jaundice.
00:59
Remember that jaundice, mixed picture.
01:01
All depends as to how much damage has taken place to liver.
01:04
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.
01:13
In viral, it would be more ALT.
01:16
Can cause severe disease in elderly
or patients with pre-existing liver disease.
01:22
Does not – I repeat, does not lead to chronic hepatitis,
but can have relapsing course.
01:28
A – hepatitis A – you should be thinking A, acute,
not so much chronic.
01:34
Diagnosed by anti-HAV IgM antibody.
01:43
Prevention of hepatitis A.
01:44
Vaccination recommended for travelers to endemic areas.
01:49
Military workers. IV drug abusers or IV drug users.
01:55
Men who have sex with men, feco-oral is your route.
02:00
Patients with chronic liver disease.
02:02
And the reason for that, remember, A will not cause chronicity.
02:06
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.
02:16
Vaccinate, close contact of a case in which
maybe perhaps there is something
with close encounters that might have taken place.
02:26
For example, think about prisoners and convicts.
02:29
Immunoglobulin useful for passive immunity
for suspected exposure if used within two weeks.
02:36
Prevention becomes important here with hepatitis A.
02:39
This is where your focus should be, approximately two weeks.