Hepatitis A: What to obtain for patient history - history of blood transfusion
msm
poor sanitation
travel to developing nations (contaminated food or water!)
exposure to an infected person
family history
T/F most cases of Hep A are symptomatic - TRUE
What cases of hep a are not symptomatic? - children under 6 years old (70% are
symptomatic)
What are some clinical presentations for Hep A? - flu-like symptoms
fever
fatigue
loss of appetite
N/V/D
abd pain
dark urine
CLAY COLORED STOOLS
joint pain
jaundice: cholestasis, hyperbilirubinemia
--Decreased albumin and prolonged PT--
Hepatitis B: What to obtain for patient history - 75% positive cases in Asia
Hemodialysis
Multiple blood transfusions (esp internationally)
use of immunosuppressive drugs
Perinatal - HEP B status of pregnant mothers
multiple sex partners
household infection of HBV
occupational exposure
IVDU
Nosocomial
Is Hep B acute or chronic? - BOTH! Can be acute or chronic
What to look for (history) in acute Hep b infection? - exposure with infected blood or
fluid within the past few months
What to look for (history) in chronic Hep B infection? - history of risk factors, serologic
testing (+) for 6 months
, Clinical Presentations of ACUTE Hep B - FLU LIKE SYMPTOMS
general illness
anorexia
N/V
body aches
mild fever
dark urine
jaundice
Clinical presentations for chronic Hep B - CAN BE ASYMPTOMATIC
Prodromal period: mild symptoms appear
RUQ pain 2/2 hepatomegaly
fatigue
joint pain
Physical findings with HEP B? - hepatosplenomegaly
spider veins
jaundice
ascites
peripheral edema
How long is prodromal period of Hep B? - 1-4 months
What is serum sickness in Hep B? - immune complex medicate hypersensitivity reaction
that classical presents with:
fever
rash
polyarthritis
polyarthralgias
Is Hepatitis C chronic or acute? - CHRONIC
What patient history should be collected with Hepatitis C infection? - born between
1945-1965
IVDU
Race
long term hemodialysis
INDU
jail time
blood transfusions before 1992
perinatal
HIV +
unregulated tattoo
nosocomial
travel to developing nations
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