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Semelhante a Acute liver disease.pptx
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Acute liver disease.pptx
- 1. Acute Liver disease Dr. Omnia Mahmoud Khalifa Internal medicine cosultant. Egyption fellowship
- 2. Causes 1- viral hepatitis virus A,B,C,D, EPV V, yellow fever 2- Non viral infection : Toxoplasma , leptospira,coxiella. 3-Drugs : alcohol, paracetamol, halothan , monoamine oxidase inhibitors 4- poisons : aflatoxin , carbon tetrachloride, tetracycline 5- Miscellaneous : pregnancy, circulatory insufficiency Wilson's disease
- 3. Viral Hepatitis •HAV : commonest •HBV •HCV •HDV •HEV •HGV •Fecal-oral •Intravenous , sexual,, saliva,, semin •Blood •Blood •Foecal-oral •Blood
- 4. Incubation period -HAV : 15-45 d - HBV : 30-180 d -HCV : 15-150 d - HDV : 30--. 180 d - HEV:. 15- 60 d
- 6. A Pre- icteric stage B Icteric stage C Convalescent stage
- 7. A Anorexia,nausea,v omiting ,diarhea,malaise,p ruritis B Fever upper abd. Pain ,hepatic tenderness C Maculopapular rash ,polyatharitis D Vasculitis, glomerulonephriti s Pre-icteric stage
- 8. A Jaundice,dark urine,pale stool B Sever cases .....fulminant hepatic F. C Hepatosplenomegaly E Lymphadenopathy Icteric stage
- 9. A Up to 6 month C Extrahepatic manifestation in HCV E Agranulocytosis,a plastic anemia,neurologic al problems Convalesant stage
- 10. Investegations
- 11. Liver function test - preicteric stage *Bilirubin -------------normal *Bilirubinuria *Raised AST,ALT Icteric stage * Rasied serum bilirubin *Rasied ALT,.AST above 500u/l *ALK p less than 300u/l
- 12. Haematological test *Leucopenia *Lymphocytosis *Prolonged P.T. in sever cases Immunological test HAV *Acute infection .......HAV-IgM for 12 w *Previous infection .....HAV-IgG
- 13. HBV HBsAg....before liver D. .....carrier .........chronic hepatitis HBV HBcAg....not seen in blood HBeAg......chronic infection HBV Anti-HBs......vaccine ..........recover AntiHBc-IgM.....acute infection HBV-DNA ( pCR)
- 16. THANKS