Hepatitis A

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.