GI 2 liver.txt

  1. Hepatitis A virus (HAV)
    • formerly known as infectious hepatitis
    • symptoms develop 2-6 weeks after exposure
    • water or food is usual source of infection
    • mild in children, more severe in adults
    • causes little to no liver damage
    • immunoglobulin injections provide protection for people exposed to it
    • treatments include Hep A vaccine or Twinrix (also protects against Hep B)
    • exposure provides lifetime immunity
  2. Hepatitis B virus (HBV)
    • formerly known as serum hepatitis
    • symptoms develop 2-6 months after exposure
    • fulminating form is sudden in onset, progresses rapidly and is fatal
    • increases risk for liver damage, including cirrhosis and liver cancer
    • treatments include Hep B vaccine, Hep B immune globulin or Twinrix
  3. Hepatitis C virus (HCV)
    • most HCV infected people have no symptoms
    • may not learn of infection until liver damage found during routine medical tests decades later
    • ~20% of those affected develop cirrhosis and some will develop end-stage liver disease
    • disease persists for months or years
    • treatments include antiviral medications or liver transplant for end-stage liver disease
  4. Hepatitis D virus (HDV)
    • uncommon, unique infection requires HBV to replicate and infect other hepatocytes
    • more common in adults than children
    • higher incidence in IV drug users and in persons from the Mediterranean basin
    • complete clinical recovery and clearance of HBV and HDV co-infection is most common outcome
    • complication: chronic infection with HBV and HDV in less than 5% of patients
    • complication: co-infection or superinfection with HBV and HDV which may result in fulminant liver failure in 1-5% of patients
    • some patients may develop cirrhosis and possibly progress to hepatocellular carcinoma
  5. Hepatits E virus (HEV)
    • very rare in US but leading cause of infectious hepatitis epidemics worldwide (third world countries)
    • not recognized as a distinct human disease until 1980 by WHO
    • transmitted primarily through fecal-contaminated drinking water
    • symptoms develop 3-8 weeks after exposure
    • no commercially available vaccine exists for prevention
    • no evidence that Hep E progresses into chronic disease
  6. Cirrhosis of the liver
    • chronic liver disease characterized by replacement of liver tissue by fibrous connective tissue, scar tissue and regenerative nodules
    • all changes result in liver dysfunction
    • normal liver is very organized, cirrhotic liver disorganized (central vein is absent, nodules of parenchyma encircled by fibrous septa)
  7. Causes of cirrhosis of the liver
    • alcoholism
    • Hep B & C
    • non-alcoholic fatty liver disease
    • chronic inflammation of the bile ducts
    • iron or copper accumulation in the liver
  8. Stages of liver damage
    • liver enlarges
    • impaired circulation
    • other abdominal organs swell
    • spontaneous hemorrhaging may occur
  9. Signs and symptoms of cirrhotic liver
    • ascites
    • hypoalbuminemia
    • jaundice
    • estrogen accumulation in men
    • testicular atrophy
    • neurological disorders
    • hepatic coma
  10. Treatment for cirrhosis of the liver
    • no effect treatment to reverse damage
    • treat edema with diuretics
    • treat portal vein hypertension with beta-adrenergic receptor antagonists
    • liver transplant
  11. Hepatocellular carcinoma (liver cancer)
    • primary malignancy
    • rare with a high mortality rate
    • more common in Africa & Asia
    • caused by viral Hep B, C virus; cirrhosis or aflatoxin
  12. Symptoms of liver cancer
    • weight loss
    • enlarged abdomen
    • pain in upper right quadrant
    • easy bruising or bleeding
    • ascites (if tumor blocks portal vein)
    • jaundice (if tumor blocks biliary ducts)
  13. Tests and diagnosis for liver cancer
    • liver enzymes
    • abdominal CT scan/ultrasound
    • liver biopsy
    • liver nuclear scan
    • serum alpha-fetoprotein
Card Set
GI 2 liver.txt
GI part 2, liver