Hepatitis and Liver Disease medium

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Questions and Answers

What condition is primarily associated with the immune system attacking bile ducts?

Haemochromatosis

Primary biliary cirrhosis (correct)

Liver cysts

Hepatocellular carcinoma

Which of the following treatments is used for primary biliary cirrhosis?

Surgical intervention

Phlebotomy

Pain management medications

Ursodeoxycholic acid (correct)

Which type of liver cancer is most commonly linked with cirrhosis?

Hepatocellular carcinoma (correct)

Liver metastasis

Secondary liver cancer

Cholangiocarcinoma

What is the main method of transmission for Hepatitis A?

Fecal-oral route Signup and view all the answers

Which condition is characterized by iron overload and may lead to liver cancer?

Haemochromatosis Signup and view all the answers

Which of the following is NOT a common symptom of primary biliary cirrhosis?

Nausea Signup and view all the answers

What is a major complication of untreated primary biliary cirrhosis?

Portal hypertension Signup and view all the answers

What treatment is NOT typically associated with managing haemochromatosis?

Antiviral therapy Signup and view all the answers

What is a common irreversible consequence of cirrhosis?

Liver failure Signup and view all the answers

Which of the following symptoms is directly associated with liver cirrhosis?

Palmar erythema Signup and view all the answers

What action can lead to recovery from alcoholic hepatitis in the early stages?

Stop drinking alcohol permanently Signup and view all the answers

Which condition can result from non-alcoholic fatty liver disease over time?

Cirrhosis Signup and view all the answers

What dietary alteration is often recommended for managing cirrhosis?

Low salt diet Signup and view all the answers

Which of the following is NOT a symptom of cirrhosis?

Palpitations Signup and view all the answers

Which is a treatment option for managing complications of cirrhosis?

Liver transplant Signup and view all the answers

What stage follows liver inflammation in non-alcoholic fatty liver disease?

Fibrosis Signup and view all the answers

What symptom is associated with the advanced stages of liver disease, including cirrhosis?

Ascites Signup and view all the answers

What is one of the primary functions of the liver related to blood?

Fights infection by capturing and digesting pathogens Signup and view all the answers

Which of the following lifestyle changes is NOT recommended for preventing liver disease?

Excessive alcohol consumption Signup and view all the answers

How does the liver respond to glucose after a meal?

Transforms glucose into glycogen for storage Signup and view all the answers

What type of diseases can cause damage to the liver?

Alcohol, viral infections, and immune system disorders Signup and view all the answers

What substance does the liver produce that is essential for fat digestion?

Bile Signup and view all the answers

Which vitamin is NOT stored in the liver?

Vitamin C Signup and view all the answers

What is primary biliary cirrhosis related to?

The body's immune system attacking the liver Signup and view all the answers

How may liver disease affect dental treatment planning?

The use of certain medications may be contraindicated Signup and view all the answers

What is NOT a function of the liver?

Stores excess protein for muscle growth Signup and view all the answers

What can excessive alcohol consumption lead to regarding liver health?

Permanent liver damage Signup and view all the answers

What is a significant symptom of liver disease?

Jaundice (yellowing of skin and eyes) Signup and view all the answers

What is the most effective treatment for chronic Hepatitis B?

Peginterferon alfa-2a Signup and view all the answers

What percentage of individuals develop an immune response after receiving three doses of the Hepatitis B vaccine?

95% Signup and view all the answers

Which behavior is recommended to prevent the transmission of Hepatitis B?

Getting vaccinated Signup and view all the answers

Which of the following statements regarding Hepatitis C is true?

Long-term complications can include liver cancer. Signup and view all the answers

What is the optimal timing for administering Hepatitis B immunoglobulin after exposure?

Within 48 hours Signup and view all the answers

Which of the following is NOT a recommended practice for healthcare professionals to avoid Hepatitis B transmission?

Sharing needles Signup and view all the answers

What side effects are commonly associated with antiviral medications for chronic Hepatitis B?

Nausea and dizziness Signup and view all the answers

How can hepatitis B be transmitted from an infected mother to her child?

During delivery Signup and view all the answers

What percentage of babies born to infected mothers develop chronic hepatitis B?

90% Signup and view all the answers

Which of the following body fluids has the highest concentration of the hepatitis B virus?

Blood Signup and view all the answers

What is the incubation period for hepatitis B infection?

45 to 180 days Signup and view all the answers

Which symptom is NOT typically associated with hepatitis B infection?

Severe hair loss Signup and view all the answers

How long can the hepatitis B virus survive outside the human body?

7 days Signup and view all the answers

What is the main reason chronic hepatitis B carriers are at a higher risk of hepatocellular carcinoma?

They have a higher amount of the virus in their blood. Signup and view all the answers

Vaccination against hepatitis B is recommended for which group?

All healthcare workers Signup and view all the answers

Which method does NOT transmit hepatitis B?

Coughing gestures Signup and view all the answers

What are the potential long-term effects of chronic hepatitis B?

Cirrhosis and liver cancer Signup and view all the answers

Study Notes

Liver Disease

The liver is the largest internal organ in the body, located below the diaphragm in the right upper abdominal quadrant.
It is the largest gland in the body, secreting bile that is stored in the gallbladder.
The liver can regenerate (entirely) from as little as 25% of the original liver tissue.
The liver filters and cleanses the blood; it makes and breaks down sugars, proteins, and fats; it stores vitamins A, D, E, K, and B12; it produces bile, essential for fat digestion; it stores minerals such as iron and copper; it removes metabolic products and toxins from the blood; and it fights infection, capturing and digesting bacteria, fungi, parasites, and cellular debris.
It turns glucose into glycogen, regulates glucose and cholesterol levels, makes essential proteins (e.g., clotting factors, albumin, hormones, transporter proteins, complement), underlies normal haemostasis, and produces thrombopoietin that stimulates bone marrow to produce platelets.
The liver breaks down haemoglobin, cholesterol, proteins, sex steroids, and many medicines (e.g., alcohol, LA, analgesics, antimicrobials, sedatives).

GDC Learning Outcomes

Explain general and systemic disease relevance to oral health.
Describe relevant and appropriate physiology and explain its application to patient management.
Describe the properties of relevant medicines and therapeutic agents, and discuss their application to patient management.

Aim

Outline liver disease and its relevance to hygienists/therapists.

Learning Outcomes

List the liver's functions.
Describe how a diseased liver functions.
Recognize liver disease symptoms.
Explain the relevance of liver disease to dental hygienists/therapists.
State how a dental treatment plan might need to be modified due to liver disease.

Liver Damage

The liver can renew and repair itself to a point.
Damaged by alcohol, viral infections (Hepatitis A-E), non-alcoholic fatty liver disease, primary biliary cirrhosis, tumors, and haemochromatosis.

The liver filters alcohol to remove it from the body.
Each time this happens, some liver cells die.
The liver needs time to regenerate and make new cells if alcohol intake is excessive.
Excessive alcohol intake over long periods can prevent liver recovery, leading to serious and permanent damage.

Alcoholic fatty liver disease (usually no symptoms, reversible)
Alcoholic hepatitis (inflammation of the liver, potentially reversible with complete cessation of alcohol use)
Cirrhosis (scarring of the liver, irreversible, preventing normal function)
Liver failure (complete liver dysfunction).

Symptoms of Cirrhosis

Often no symptoms until significant liver damage.
Early symptoms can include tiredness/weakness, nausea/loss of appetite, weight loss, palmar erythema (liver palms), spider nevi, finger clubbing, and sialosis.
Later symptoms include jaundice (due to bile pigment buildup), itchy skin, dark urine, and tarry-looking feces; easily bleeding or bruising; loss of libido; swollen legs or abdomen (ascites); gynecomastia or testicular atrophy; esophageal varices; encephalopathy (leading to confusion); and liver cancer.

Treatment of Cirrhosis

Not curable, but symptoms and complications can be managed.
Lifestyle changes, including stopping alcohol consumption, a healthy diet (low protein and low salt), weight loss, and smoking cessation.
Medicines such as diuretics, beta-blockers, and creams can help to reduce skin itching.
Liver transplant may be an option.

Non-Alcoholic Fatty Liver Disease

Build-up of fat in the liver, not caused by alcohol.
Often related to obesity.
Has four stages, progressing over many years.
Early stages are typically symptom-free.
Symptoms of fibrosis include abdominal pain, tiredness, and weight loss.
Symptoms of cirrhosis are similar but more severe.

Treatment of Non-Alcoholic Fatty Liver Disease

Healthy lifestyle choices, including weight loss, a healthy diet, exercise, and quitting alcohol and smoking.
Treatment of complications (e.g., diabetes, hypertension, high cholesterol).
Liver transplant if cirrhosis develops.

Other Causes of Liver Damage

Primary biliary cirrhosis: Immune system attacks bile ducts, leading to bile buildup, liver cirrhosis, and potential long-term complications.
Tumors and cysts: include primary liver (hepatocellular carcinoma, often preceded by cirrhosis) or secondary liver cancer (from other organs such as breast, bowel, lung, ovary) and liver cysts.
Haemochromatosis: An inherited condition leading to iron overload, damaging the liver, pancreas, and heart, increasing the risk of liver cancer.

Viral Hepatitis

Viral infection of the liver, (A, B, C, D, E).
Hepatitis A (faecal-oral route, infection with contaminated food/drink).
- Symptoms usually last a few months.
- No specific treatment other than pain, nausea, and itching relief.
- Prevented by vaccination.
Hepatitis B (spread through blood, sexual contact, needles, shared razors/toothbrushes).
- 5% become chronic carriers.
- Can lead to cirrhosis and liver cancer.
- Vaccination available.
Hepatitis C (transmission through blood, needlestick injury).
- Often asymptomatic.
- Can lead to chronic hepatitis, liver failure, liver cancer.
- No vaccine.
Hep D (only infects people with Hep B—leads to liver issues and complications).
Hep E (faeco-oral route—similar to Hep A).

Dental Aspects of Liver Disease

Dental neglect: Often seen in alcoholic cirrhosis due to poorly controlled OH, dental erosion, gastric reflux. Increased incidence of caries, periodontal disease, and lack of dental care.
Sialosis: Enlarged parotid glands, sometimes after liver transplant.
Gingival overgrowth: Possible side effect of anti-rejection drugs taken post-liver transplant.
Delayed or discoloured teeth: Possible in children awaiting liver transplants.
Dental management: increased bleeding risk, risk of poor wound healing, issues with drug metabolism, require universal precautions, possibly antibiotic cover for invasive procedures, and avoid elective procedures for 6 months following transplant.
Drug considerations: Reduced dose of LA (local anesthetic), use of articaine instead of lidocaine, avoid NSAIDS, and possibly issues metabolising some drugs.
Prevention and OHI: Importance of good oral hygiene, diet analysis, fluoride supplements, alcohol and smoking cessation.

Diagnosis

Blood tests (serological tests, Hep B antigens, Hep B antibodies) are used to diagnose liver conditions.

Treatment

Hepatitis B treatment with rest, analgesia, symptom-relief medication (e.g., metoclopromide for nausea), peginterferon alfa-2a (for chronic cases), antiviral drugs (tenofovir/entecavir).
Hepatitis C treatment with direct-acting antiviral medications.

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Description

This quiz explores the essential functions of the liver, the largest internal organ in the human body. Learn about its role in metabolism, detoxification, and its remarkable ability to regenerate. Test your knowledge on how the liver combats infection and maintains overall health.