Hepatitis.pdf - Hepatitis Hepatitis inflammation of the liver usually caused by virus exposure to alcohol drugs toxins pathogens Acute or chronic Report

Hepatitis Hepatitis Manifestations of Acute Hepatitis Risk factors  inflammation of the liver  usually caused by virus  exposure to alcohol, drugs, toxins, pathogens  Acute or chronic  Report all cases to health department Pathophysiology  Inflammatory process; damages hepatic cells and disrupts liver function  Cell-mediated immune responses damage hepatocytes and Kupffer cells, leading to hyperplasia, necrosis and cellular regeneration.  The flow of bile through bile canaliculi and into the biliary system can be impaired by the inflammatory process leading to jaundice.  Impaired bile flow leads to jaundice  Liver hyperplasia, necrosis and cellular regeneration  The metabolism of nutrients, drugs, alcohol, and toxins, and the process of bile elimination are disrupted by the inflammation of hepatitis Viral Hepatitis  Caused by 5 viruses  Hepatitis A (HAV)  Hepatitis B (HBV)  Hepatitis C (HBC)  Hepatitis D (HBD)  Hepatitis E (HBE)  All of the hepatitis viruses are RNA viruses; HBV is a DNA virus.  The viruses differ from one another in mode of transmission, incubation period, the severity and type of liver damage they caused, and their ability to become chronic or develop a carrier (asymptomatic) state.   No manifestations are present during the incubation period after exposure to the virus:  The prodromal or preicteric (before jaundice) phase may begin abruptly or insidiously, with general malaise, anorexia, fatigue and muscle and body aches.  These manifestations often are mistaken for the flu. N/V, diarrhea or constipation may develop, as well as mild RUQ abd. Pain. Chills and fever may be present.  The icteric (jaundiced) phase begins 5-10 days after onset of symptoms.  It is heralded by jaundice of the sclera, skin, and mucous membranes. Inflammation of liver and bile ducts prevents bilirubin from being excreted into the small intestine.  The serum bilirubin levels are elevated, causing yellowing of the skin and mucous membranes.  Pruritus may develop due to deposition of bile salts on the skin.  The stools are light brown or clay colored because bile pigment is not excreted through the normal fecal pathway. Instead the pigment is excreted by the kidneys, causing the urine to turn brown.  The convalescent phase follows jaundice and last several wk.s Serum enzymes decrease, liver pain decrease, and GI symptoms and weakness subside.   Preicteral or Prodromal Phase  Flulike symptoms: chills, fever, fatigue, muscle and body aches  Gastrointestinal: anorexia, N/V, diarrhea, constipation  Muscle aches, polyarthritis  Mild RUQ abd pain and tenderness  Icteric phase  Jaundice  Pruritus  Clay-colored stools  Brown urine  Decrease in preicteric phase symptoms : appetite improved, no fever 