Hepatitis

Question 1

• Transmitted through consumption of contaminated water or food, and fecal-oral route to include certain sex practices.
• Infections are typically mild and acute, with most making a full recovery & gaining lifelong immunity.
• Most people in areas of the world with poor sanitation have been infected with this virus.

Answer 1

Hepatitis A (HAV)

Question 2

• Transmitted through exposure to infective blood, semen, body fluids, contaminated blood products, and IV drug use

Answer 2

Hepatitis B (HBV)

Question 3

Transmitted through exposure to infective blood, contaminated blood & blood products, and IV drug use. Sexual transmission is possible but less common.

Answer 3

Hepatitis C (HCV)

Question 4

• Infections occur only with HBV infection.
• Dual infection of HBV result in a more serious disease and worse outcome.

Answer 4

Hepatitis D (HDV)

Question 5

Which vaccine provides protection from HDV infection?

Answer 5

Hep B vaccination

Question 6

• Transmitted through consumption of contaminated water or food.
• Common cause of hepatitis outbreaks in developing nations.
• Vaccines exist but are not widely available.

Answer 6

Hepatitis E (HEV)

Question 7

Inflammation of the liver from infection, toxins, autoimmune diseases, metabolic disorders

Answer 7

Hepatitis

Question 8

• Typically an acute illness that many children in developing nations are infected by and remain asymptomatic. Chronic infection does not occur

Answer 8

Hep A

Question 9

Can both remain dormant in the liver and cause chronic hepatitis & hepatocellular carcinoma

Answer 9

HBV & HCV

Question 10

Presentation:
- Fatigue, fever, muscle/joint pains, runny nose, pharyngitis, abdominal pain, nausea, vomiting, anorexia.
- Within 1-3 weeks, jaundice & RUQ pain develops
- Secondary to the virus infecting & killing hepatocytes
- Hepatocytes death releases liver enzymes in the blood
- Hepatic dysfunction leads to increased bilirubin & jaundice

Answer 10

Hepatitis

Question 11

Physical findings:
- Low-grade fever
- Hepatomegaly with Liver tenderness
- Jaundice & Scleral icterus
- Right upper quadrant abdominal pain.
- Dark or brown colored urine
- Gray/clay colored stool

Answer 11

Hepatitis

Question 12

Labs for Hepatitis

Answer 12

• Hepatitis panel: testing for presence of IgM and IgG and for specific components of viral hepatitis confirms diagnosis
• WBC: Normal to low.
• UA: Proteinuria and dark urine (bilirubinuria)
• Liver function Test (LFT)
• Complete Metabolic Panel (CMP): Elevation in bilirubin and alkaline phosphates.

Question 13

Treatment of Hepatitis

Answer 13

• Supportive/palliative interventions & patient
  monitoring.
• Med Advice for further recommendations.
• Patient will require Medevac as soon as operational
  conditions allow, however, typically does not require
  emergent evacuation.
• Ensure proper hydration & nutrition, and place patient SIQ

Question 14

Prevention of Hepatitis

Answer 14

• Vaccinations
• Proper hygiene and handwashing
• Appropriate use of PPE and following procedures to avoid needle sticks
• Use of condoms if participating in risky sexual activity.

Question 15

Disposition of hepatitis

Answer 15

Patients should be placed on a light-duty/bed-rest status based on the severity of the disease, and evacuated to definitive care as soon as possible for serious cases.