Hepatitis
SUMMARY
Symptoms
NOTE: Check for other STIs too.
Management
Symptoms
- RUQ pain
- Flu-like sx
- Jaundice/ pruritis
- Pale stools/ dark urine
- Weight loss
- Lethargy
- n+v
- Extrahepatic (arthralgia, urticaria)
- Hep A/ E: Travel hx, faecal-oral (food, water), no vaccination hx
- Hep B: IVDU, unprotected sex, no vaccination hx, health worker
- Hep C: Tattoo, blood transfusion, IVDU, traumatic unprotected sex, accupuncture, health worker
- Hep D: close contact with carrier
- Autoimmune: FHx
- Jaundice (Usually Hep A and sometimes B, almost never C)
- Hepatosplenomegaly/ adenopathy
- Autoimmune signs for autoimmune hepatitis
- Bloods: LFT, Hepatitis screen, IgG levels, autoab (ANA, SMA, LKM1)
- Others: Biopsy (autoimmune)
NOTE: Check for other STIs too.
Management
- Hep A: Supportive, avoid alcohol
- Hep B: Supportive, avoid alcohol. Chronic = PEGinterferon/ antivirals
- Hep C: Wait until moderate then PEGinterferon + ribavirin
- Hep D: Interferon alpha
- Hep E: Supportive, avoid alcohol
- Autoimmune: Prednisolone/ Azathioprine --> Liver transplant
Source
http://www.nlm.nih.gov/medlineplus/ency/article/001154.htm
Toronto Notes 2012
OHCM 9th Ed 2014
http://www.nlm.nih.gov/medlineplus/ency/article/001154.htm
Toronto Notes 2012
OHCM 9th Ed 2014