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Questions and Answers
What is the main transmission route for Hepatitis A virus?
Which hepatitis virus is associated with a carrier state?
Which of the following is a primary risk group for Hepatitis C infection?
What is a notable complication of liver cirrhosis that has dental implications?
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What is the incubation period range for Hepatitis B virus?
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What is the first action a dentist should take regarding HBsAg status?
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What type of virus is Hepatitis B classified as?
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Which stage of Alcoholic Liver Disease (ALD) is characterized by hepatocellular damage and symptoms like jaundice and fever?
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Which of the following hepatitis viruses does not have a known vaccine available?
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Which of the following is NOT a symptom of liver cirrhosis?
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Which dental consideration is essential when managing a patient with liver disease?
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Which of these statements about Hepatitis D virus is true?
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What type of information should be provided to patients to prevent Alcoholic Liver Disease?
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What is a common diagnostic method for detecting liver cirrhosis?
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Which of the following laboratory values should be monitored in patients with liver disease?
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Among the following causes, which is primarily associated with the development of liver cirrhosis?
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What is the gold standard for the diagnosis of liver cirrhosis?
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Which of the following is a common complication associated with liver cirrhosis?
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What symptom is typically present in a patient with hepatocellular carcinoma?
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Which of the following is an important dental consideration for patients with liver disease?
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What is the sex ratio typically observed in cases of hepatocellular carcinoma?
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What are the causes of hepatic jaundice?
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Which of the following signifies jaundice in a patient?
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What is the primary management strategy for patients with end-stage liver cirrhosis?
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Study Notes
Hepatitis Overview
- Routine testing for HBsAg status is essential for dentists.
- Informed consent must be obtained from patients before any procedures.
- Dental practice should be halted until seroconversion occurs in patients with hepatitis.
Alcoholic Liver Disease (ALD)
- ALD results from alcohol abuse, leading to liver damage.
- Classified into three stages:
- Fatty liver: Mild and reversible liver injury.
- Alcoholic hepatitis: Characterized by hepatocellular damage, jaundice, fever, and ascites.
- Cirrhosis: Irreversible fibrosis and nodule formation in liver.
- Symptoms include puffy face, unexplained injuries, memory deficits, jaundice, ascites, white nails, and a sweet breath odour.
Diagnosis and Investigation of ALD
- Diagnosis involves patient history, clinical examination, breath alcohol detection, and family history.
- Dental considerations include:
- Consult with a physician on health status, medications, and laboratory values.
- Avoid drugs metabolized by the liver.
- For surgical procedures with abnormal lab values, consider fresh frozen plasma or vitamin K.
- Provide alcohol prevention information and refer to rehabilitation services.
Liver Cirrhosis
- Defined as replacement of liver tissue by fibrosis and nodules, resulting in loss of function.
- Common causes include hepatitis B and C infections, alcohol, and certain drugs.
- Symptoms of cirrhosis: lethargy, itching, jaundice, and ascites.
- Signs include hepatomegaly, splenomegaly, spider nevi, palmar erythema, and oesophageal varices.
- Oral manifestations: jaundice in oral mucosa and bleeding tendencies.
- Avoid hepatotoxic drugs and consult a physician before any invasive procedures.
- Diagnosis confirmed through liver biopsy and blood tests; treatment is often a liver transplant for end-stage cirrhosis.
Liver Cancer (Hepatocellular Carcinoma)
- A common malignant tumor of the liver, often linked to chronic HBV or HCV.
- Symptoms include abdominal pain, weight loss, ascites, fever, jaundice, and hepatomegaly.
- Oral signs: jaundice in the mucosa; possible metastasis to oral tissues.
- Diagnosis involves liver biopsy and increased alpha-fetoprotein levels.
- Treatment options include resection, liver transplant, chemotherapy, and pain management.
Jaundice
- Jaundice characterized by yellow discoloration of skin and sclera due to bilirubin deposition.
- Clinically visible when bilirubin levels exceed 3 mg/L.
- Causes include:
- Prehepatic jaundice: Due to conditions like hereditary spherocytosis and sickle cell disease.
- Hepatic jaundice: Results from viral hepatitis or liver disease.
- Cholestatic jaundice: Causes from biliary obstruction.
Viral Hepatitis
- Inflammation of the liver caused by several viruses, presenting in acute and chronic forms.
- Major hepatitis viruses: A, B, C, D, and E, plus others like EBV and CMV.
Hepatitis A
- RNA virus, transmitted via the fecal-oral route.
- Risk groups include those with poor hygiene.
- Incubation period is 15-50 days; no carrier state exists.
- Prophylaxis includes immunoglobulin and vaccination.
Hepatitis B
- DNA virus, spread percutaneously, sexually, or perinatally.
- High-risk groups: IV drug users, healthcare workers, and individuals with multiple partners.
- Incubation: 30-180 days; has a carrier state.
- Prophylaxis through immunoglobulin and vaccination can provide lifelong immunity.
Hepatitis C
- RNA virus, transmitted primarily through blood and occasionally sexually.
- High-risk groups similar to Hepatitis B; incubation: 15-160 days.
- Significant carrier state (50-80%); no vaccine available.
Hepatitis D
- Defective RNA virus, can only infect individuals already infected with hepatitis B.
- Transmission routes similar to Hepatitis B.
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Description
This quiz covers key aspects of Alcoholic Liver Disease (ALD), including its diagnosis, symptoms, and necessary investigations. It emphasizes the importance of monitoring HBsAg status and obtaining informed consent in dental practices for patients with liver complications. Test your knowledge on the classification and management of ALD.
