Hepatitis and Liver Disease hard
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Questions and Answers

What is a significant complication associated with untreated primary biliary cirrhosis?

  • Kidney failure
  • Reduced bile production
  • Increased risk of diabetes
  • Portal hypertension (correct)

Which treatment option is commonly used for managing haemochromatosis?

  • Antibiotics
  • Immunosuppressants
  • Insulin therapy
  • Phlebotomy (correct)

Which hepatitis virus is primarily transmitted through fecal-oral contamination?

  • Hepatitis A (correct)
  • Hepatitis B
  • Hepatitis D
  • Hepatitis C

What is the most common type of primary liver cancer associated with cirrhosis?

<p>Hepatocellular carcinoma (B)</p> Signup and view all the answers

Which of the following is NOT a function of the liver?

<p>Synthesizes antibodies to fight infections (D)</p> Signup and view all the answers

What is the primary factor causing liver damage in cases of alcoholic liver disease?

<p>Alcohol metabolism and its toxic byproducts (B)</p> Signup and view all the answers

What condition leads to the immune system mistakenly attacking bile ducts?

<p>Primary biliary cirrhosis (B)</p> Signup and view all the answers

What treatment is often used to relieve symptoms of primary biliary cirrhosis, such as itching?

<p>Ursodeoxycholic acid (B)</p> Signup and view all the answers

How might liver disease affect the dental treatment plan for a patient?

<p>Sedative administration may need adjustments to avoid complications. (D)</p> Signup and view all the answers

What is a potential consequence of iron overload in haemochromatosis?

<p>Decreased bone density (B)</p> Signup and view all the answers

Which of the following is a symptom commonly associated with liver disease?

<p>Jaundice (yellowing of the skin and eyes) (A)</p> Signup and view all the answers

Which type of liver disease is primarily caused by the immune system attacking liver cells?

<p>Primary biliary cirrhosis (A)</p> Signup and view all the answers

What are liver cysts primarily associated with?

<p>Congenital conditions (B)</p> Signup and view all the answers

What percentage of infected babies with Hepatitis B are likely to develop chronic hepatitis?

<p>90% (D)</p> Signup and view all the answers

What is one key responsibility of the liver related to glucose management?

<p>Storing glucose as glycogen (A)</p> Signup and view all the answers

Which bodily fluid contains the highest concentration of the hepatitis B virus?

<p>Blood (A)</p> Signup and view all the answers

Which of the following correctly describes a way in which the liver fights infection?

<p>Capturing and digesting bacteria and cellular debris (D)</p> Signup and view all the answers

Which substance does the liver break down as part of its detoxification role?

<p>Hemoglobin, proteins, and sex steroids (C)</p> Signup and view all the answers

What is the average incubation period for Hepatitis B infection?

<p>60 days (D)</p> Signup and view all the answers

Which of the following is NOT a mode of transmission for Hepatitis B?

<p>Sharing eating utensils (A)</p> Signup and view all the answers

What percentage of individuals with chronic Hepatitis B carry the virus for life?

<p>5% (C)</p> Signup and view all the answers

What kind of symptoms might develop two to three months after exposure to Hepatitis B?

<p>Flu-like symptoms (A)</p> Signup and view all the answers

Hepatitis B can survive outside the human body for how long?

<p>7 days (A)</p> Signup and view all the answers

What is the seroconversion risk for Hepatitis B after a needle stick injury?

<p>1 in 3 (B)</p> Signup and view all the answers

What is used as a marker for infection in Hepatitis B?

<p>Hepatitis B antigens (C)</p> Signup and view all the answers

What is the purpose of Peginterferon alfa-2a in the treatment of Chronic Hepatitis B?

<p>To improve immune response against Hep B (A)</p> Signup and view all the answers

What is the recommended duration for the Hepatitis B vaccination strategy?

<p>3 doses at month 0, 1, and 6 (C)</p> Signup and view all the answers

Which practice should be avoided to minimize the risk of Hepatitis B transmission?

<p>Sharing razors (A)</p> Signup and view all the answers

What is the effectiveness of the Hepatitis B immunoglobulin if administered within 48 hours of exposure?

<p>Most effective (D)</p> Signup and view all the answers

What is a common long-term complication of Chronic Hepatitis C?

<p>Cirrhosis (D)</p> Signup and view all the answers

Which of the following is NOT a recommended prevention method for Hepatitis B?

<p>Sharing needles for drug use (C)</p> Signup and view all the answers

What type of virus is Hepatitis C classified as?

<p>Single-stranded RNA virus (B)</p> Signup and view all the answers

Which statement best describes alcoholic hepatitis?

<p>Inflammation of the liver that can be reversible in early stages if drinking is stopped. (B)</p> Signup and view all the answers

What is a common symptom of cirrhosis?

<p>Nausea and loss of appetite. (B)</p> Signup and view all the answers

Which of the following is true regarding non-alcoholic fatty liver disease?

<p>It can progress to cirrhosis in some patients, but often has no symptoms in early stages. (C)</p> Signup and view all the answers

What treatment options are available for cirrhosis?

<p>Lifestyle changes, treatment of symptoms, and possibly liver transplant. (C)</p> Signup and view all the answers

Which symptom is specifically associated with liver cirrhosis?

<p>Swollen abdomen (ascites). (D)</p> Signup and view all the answers

Which factor is NOT commonly associated with non-alcoholic fatty liver disease?

<p>High alcohol consumption. (C)</p> Signup and view all the answers

Cirrhosis can lead to which of the following severe complications?

<p>Liver cancer. (A)</p> Signup and view all the answers

Which lifestyle modification is recommended for managing any form of liver disease?

<p>Maintaining a healthy weight and quitting smoking. (C)</p> Signup and view all the answers

What is a significant risk associated with chronic infections caused by Hepatitis D?

<p>Liver scarring (C)</p> Signup and view all the answers

Which characteristic is true of Hepatitis E?

<p>It is transmitted via the faeco-oral route. (D)</p> Signup and view all the answers

Which dental finding may be observed in a patient with alcoholic cirrhosis?

<p>Dental erosion from gastric reflux (A)</p> Signup and view all the answers

What is a potential outcome of neglecting dental care in liver disease patients?

<p>Higher incidence of dental caries (D)</p> Signup and view all the answers

Which factor could complicate dental management for patients who have undergone a liver transplant?

<p>Decreased metabolism of anesthetics (B)</p> Signup and view all the answers

What is a common manifestation of sialosis in patients with liver disease?

<p>Puffy cheeks due to enlarged parotid glands (A)</p> Signup and view all the answers

How does being on immunosuppressants affect dental treatment for liver transplant patients?

<p>Raises the risk of infection (D)</p> Signup and view all the answers

Which lifestyle change is recommended for minimizing health risks related to liver disease?

<p>Improved dietary habits (B)</p> Signup and view all the answers

Flashcards

Diabetes

A chronic disease where the body cannot properly regulate blood sugar levels.

Primary Biliary Cirrhosis

Liver damage caused by the immune system attacking the bile ducts.

Hepatitis

Viral infection of the liver.

Liver Transplant

Surgical procedure replacing a diseased liver with a healthy one.

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Cirrhosis

Scarring of the liver due to chronic damage.

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Haemachromotosis

Inherited condition causing iron overload in the body, damaging the liver.

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Hepatitis A

Fecal-oral transmission, common in poor sanitation areas.

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Primary Liver Cancer

Cancer originating in the liver tissue, often linked to cirrhosis.

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Liver Function

The liver filters blood, processes nutrients, produces bile, and synthesizes proteins crucial for health.

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Liver Disease Causes

Liver damage can result from alcohol abuse, viral infections (hepatitis), non-alcoholic fatty liver disease, autoimmune issues, or tumors.

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Liver Regeneration

The liver has remarkable ability to repair itself and regenerate from damage.

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Bile Function

Bile produced by the liver helps digest fats and absorb fat-soluble vitamins.

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Liver Location

The liver is a large organ located in the upper right quadrant of the abdomen, beneath the diaphragm.

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Liver Size

The liver is the largest internal organ in the body.

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Liver's role in sugar & cholesterol

The liver regulates the levels of glucose and cholesterol in the blood.

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Liver Disease Impact on Dental Care

Patients with liver disease may need adjusted dental treatment plans due to potential health considerations.

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Alcoholic Liver Disease Stages

Three stages: Fatty Liver Disease (reversible), Alcoholic Hepatitis (reversible in early stages), and Cirrhosis (irreversible scarring).

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Cirrhosis Symptoms

Often no symptoms until advanced. Symptoms can include tiredness, nausea, weight loss, jaundice, itching, enlarged abdomen, and bleeding issues.

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Cirrhosis Treatment

No cure, only symptom and complication management. Includes lifestyle changes (stop drinking, healthy diet, weight loss, stop smoking), medications (diuretics, beta-blockers), and liver transplant.

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Non-Alcoholic Fatty Liver Disease

Liver disease caused by fat buildup, unrelated to alcohol. Progresses through stages to potential cirrhosis.

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Fatty Liver Disease

Liver disease characterized by fat accumulation in liver cells.

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Alcoholic Hepatitis

Inflammation of the liver due to excessive alcohol consumption.

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Liver Regeneration

Liver's ability to repair and create new cells; requires time off from damaging substances (like alcohol).

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Symptoms Related to Liver Damage

Tiredness, nausea, weight loss, jaundice, abdominal swelling, bleeding problems

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Hepatitis B Transmission

Spread through bodily fluids like blood, semen, and vaginal fluids, also through sharing needles or razors.

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Chronic Hepatitis B Carriers

A small percentage (5%) of infected individuals carry the virus for life, facing a higher risk of liver complications.

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Hepatitis B Virus Resilience

The virus can survive outside the body for up to 7 days, making it relatively easy to spread.

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Hepatitis B Symptoms

Symptoms may be absent (asymptomatic), or include flu-like symptoms, loss of appetite, jaundice.

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Hepatitis B Incubation

The time from infection to symptom onset, varying from 45 to 180 days, averaging 60 days.

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Hepatitis B Diagnosis

Confirmed through blood tests using serological (antibody) detection.

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Hepatitis B in Children

Children can develop chronic Hepatitis B, potentially leading to permanent liver damage, with a high percentage (90%) becoming chronic cases.

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Hepatitis B Prevention

Prevention strategies include vaccination, especially for healthcare workers and, since 2017, children in many countries.

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Hepatitis B Transmission

Spread through bodily fluids, like blood and saliva.

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Hepatitis B Prevention

Vaccination is key for those at risk, offering long-lasting protection.

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Hepatitis B Treatment (Acute)

Rest, pain relievers, and medicines for nausea during acute infection.

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Hepatitis B Treatment (Chronic)

Medications like peginterferon or antivirals to control the virus, managing symptoms.

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Hepatitis C

A viral infection transmitted via bodily fluids, potentially causing long-term liver damage.

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Hepatitis C Treatment

Direct-acting antiviral medications for 8-12 weeks treat chronic Hep C.

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Hepatitis B Vaccination Schedule

Three doses are recommended, at months 0, 1, and 6.

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Universal Precautions

Treating all patients as potential carriers of Hep B to prevent infections.

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Hepatitis D

A delta virus that only infects people already infected with Hepatitis B.

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Hepatitis E

An RNA virus transmitted by the fecal-oral route, similar to Hepatitis A.

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Liver Disease Dental Findings

Dental issues like poor oral hygiene, dental neglect, erosion from acid reflux, sialosis, gingival enlargement (if on immunosuppressants), and delayed tooth eruption in children needing transplants.

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Dental Neglect

Lack of oral hygiene leading to increased cavities, inflammation, and periodontal disease.

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Sialosis

Enlarged parotid glands, causing a facial swelling.

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Liver Transplant Dental Management

Requires avoiding elective dental treatment for 6 months post-transplant due to immunosuppressants.

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Dental Management in Liver Disease

Increased bleeding risk, poor wound healing, drug metabolism issues are critical to managing dental treatment.

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Hepatitis B Transmission

Spread via bodily fluids like blood, semen, and vaginal fluids, and through sharing needles or razors.

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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 and secretes bile, which is stored in the gallbladder.
  • The liver can regenerate, repairing itself from as little as 25%.

GDC Learning Outcomes

  • Explain general and systemic diseases and their oral health relevance.
  • Describe relevant physiology and its application to patient management.
  • Describe the properties of relevant medicines and therapeutic agents, discussing their application to patient management.

Functions of the Liver

  • Filters and cleans the blood.
  • Creates and breaks down sugars, proteins, and fats.
  • Stores vitamins (A, D, E, K, and B12).
  • Produces bile, essential for digesting and absorbing fat-soluble vitamins.
  • Stores minerals such as iron and copper.
  • Removes metabolic products and toxins from the blood.
  • Fights infections by capturing and digesting bacteria, fungi, parasites, and cellular debris.
  • Converts glucose to glycogen, storing it in the liver.
  • Regulates glucose and cholesterol levels.
  • Creates essential proteins, including blood clotting factors, albumin, hormones, and transporter proteins.
  • Underlines normal blood clotting and creates thrombopoietin, stimulating platelet production.
  • Breaks down hemoglobin, cholesterol, proteins, sex hormones, and various drugs (e.g., alcohol, analgesics, antimicrobials).

Liver Damage

  • The liver can renew and repair itself up to a point.
  • Damage is caused by alcohol, viral infections (Hepatitis A-E), Non-alcoholic fatty liver disease, body's immune system (primary biliary cirrhosis), tumors, and cysts, haemochromatosis.
  • The liver breaks down alcohol.
  • Each time alcohol is broken down, some liver cells die.
  • The liver needs time to regenerate and create new cells.
  • Excessive alcohol consumption over time can prevent the liver from recovering, resulting in serious and permanent damage.
  • Alcoholic liver disease stages include: Fatty Liver Disease, Alcoholic Hepatitis, and Cirrhosis.

Symptoms of Cirrhosis

  • Often asymptomatic until severe damage.
  • May experience tiredness, weakness, nausea, loss of appetite, and weight loss.
  • Potential signs include: palmar erythema, spider naevi, finger clubbing, and sialosis.
  • Other potential symptoms include jaundice, itchy skin, dark urine, easily bleeding or bruising, loss of libido, swelling of the legs or abdomen (ascites), Gynecomastia or testicular atrophy, esophageal varices, Encephalopathy, and liver cancer.

Treatment of Cirrhosis

  • Focuses on symptom management, not a cure.
  • Lifestyle changes like stopping alcohol consumption, eating a healthy diet, losing weight, and avoiding smoking.
  • Medications might include diuretics, beta-blockers, topical creams to reduce itching.
  • Liver transplant is a potential treatment option.

Non-Alcoholic Fatty Liver Disease (NAFLD)

  • Build-up of fat in the liver, not caused by alcohol.
  • Often associated with obesity.
  • Has 4 stages (early stages are often asymptomatic).
  • Symptoms of fibrosis include abdominal pain, tiredness, and weight loss.
  • Symptoms of cirrhosis are similar to those described above.
  • Treatment focuses on lifestyle changes, including weight loss, a healthy diet, and exercise, along with managing any associated conditions (e.g., diabetes, hypertension).
  • Liver transplant may be an option if cirrhosis develops.

Other Causes of Liver Damage

  • Primary biliary cirrhosis (immune system attacks bile ducts).
  • Tumours and cysts (primary liver cancer - hepatocellular carcinoma, secondary liver cancer - metastatic, liver cysts - simple, congenital, polycystic liver disease, caused by the parasite echinococcus).
  • Haemochromatosis (inherited condition causing iron overload, damaging liver, joints, and pancreas).

Viral Hepatitis

  • Viral infection of the liver.
  • Hepatitis Viruses: A, B, C, D, E.
  • Hep A, B, and C are the most clinically significant for dentistry.

Hepatitis A

  • Caused by the Hepatitis A virus.
  • Transmitted by the faecal-oral route (contaminated food/drinks).
  • Common in areas with poor sanitation.
  • Symptoms usually resolve within a few months.
  • Prevented by vaccination.

Hepatitis B

  • Caused by the Hepatitis B virus.
  • Spread through blood, shared needles/ razors/toothbrushes/unprotected sex, and infected pregnant women to their babies.
  • Can be chronic (5% carriers).
  • Vaccination available.

Hepatitis C

  • Single-stranded RNA virus.
  • Transmitted through needles/blood splashes/bodily fluids.
  • No vaccine against Hepatitis C.
  • Often asymptomatic initially.
  • Long-term complications can lead to cirrhosis and liver failure.
  • Treated with direct acting antiviral medications.

Hepatitis D and E

  • Hepatitis D (delta virus) only infects those already carrying Hepatitis B.
  • Hepatitis E (RNA virus) is transmitted through the faecal-oral route and is similar to Hepatitis A.
  • Vaccination exists for some forms.

Dental Aspects of Liver Disease

  • Dental Neglect: Poor oral hygiene, leading to dental caries, periodontal disease, and a lack of professional dental care.
  • Alcoholic Cirrhosis: Often associated with poor oral hygiene. Dental erosion from gastric reflux can occur.
  • Sialosis/parotid enlargement: Possible if on immunosuppresants after liver transplant.
  • Gingival enlargement: May present due to immunosuppresant/antirejection drug use after a liver transplant.
  • Delayed/discoloured teeth: Children needing a liver transplant may experience delayed tooth eruption and discoloration/hypoplastic teeth.
  • Dental Management Considerations: Increased bleeding risk, poor wound healing and infection, issues metabolizing oral drugs. Vaccination with Hep B. Universal Precautions for all patients. Treatment should be deferred for a time for patients with recent liver transplants.

Dental Management

  • Control infection (universal precautions): staff should be vaccinated against Hepatitis B.
  • Treat patients with recent liver transplants with caution.
  • Universal precautions should be implemented.
  • Avoid elective procedures for six months after liver transplant.
  • Consideration to reducing local anaesthetic dosages, using different anaesthetics, and avoiding NSAIDS.
  • Prevention is crucial (oral hygiene, diet, fluoride supplements); alcohol and smoking cessation advice.

What Else to Consider

  • Reducing local anaesthetic (LA) dosages.
  • Using articaine instead of lidocaine.
  • Avoiding NSAIDs.
  • Liver function may affect patients ability to metabolize certain medications including antibiotics, such as tetracycline.

Summary

  • Functions of the liver, main causes of liver disease, symptoms of liver disease, and dental implications.

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Liver Disease And Hepatitis GN PDF

Description

This quiz covers key aspects of liver disease, emphasizing its functions, relevance to oral health, and physiological implications. It explores the liver's role in filtering blood, nutrient storage, and its regenerative capacities. Test your knowledge on the critical functions and importance of the liver.

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