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Other Types of Viral Hepatitis

by Carlo Raj, MD
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    00:01 Viral Hepatitis Miscellaneous.

    00:03 We have EBV, CMV and HSV.

    00:06 Usually cause hepatitis in immuno-compromised patient.

    00:10 Now, we have dealt with this group of viruses before.

    00:14 Actually a lot of places. For example, if there is a CMV, HSV infection and your patient is complaining of : "Doc, had ice cream yesterday and while I was eating the ice cream, I've really had pain in my throat." Odynophagia.

    00:33 Upon Upper Endoscopy, maybe you'll find ulcerations of vesicles in esophagus, your patient is most likely immuno-compromised.

    00:42 Also, CMV, HSV liver damage, immuno-compromised.

    00:48 Patients with mononucleosis may present with self-limited increased at ALT.

    00:53 Okay so with EBV, in the US, most likely your patient, in college maybe, Kissings disease, parties, sharing of beer, any of an 18 year old patient in such, who's stressfully feeling tired.

    01:10 And that this point, you're thinking about your EBV infection, mono.

    01:14 In addition, big time, you worry about the spleen, right.

    01:19 Because if there's trauma, spleenic rupture, death to your patient, no joke.

    01:24 And liver might be involved as well.

    01:27 Often times, liver and the spleen go hand in hand, don't they? Herpes.

    01:33 Hepatitis presents in pregnancy with fever, mental status changes, and in ALT. Remember now, all viral hepatitides will have which Transaminases elevated? You find a pregnant lady with an increase in ALT, you're thinking about Herpes hepatitis and with this, what are you worried about? Vertical transmission to the newborn.

    01:58 Everything that we're dealing with here is actually taking place in clinical practice today.

    02:04 These are the things and these are the scenarios that you want to be familiar with.

    02:08 And if there's anything that you're memorizing in micro, with viruses, make sure you come back and you understand who your patient is.

    02:16 Because that's how the questions will come to you.

    02:19 Each one of these will be cases.

    02:21 The faster you're able to identify your cases and who they are, the faster that you will then arrive at the proper answer in terms of diagnosis, maybe micro and maybe, perhaps, your pharmacology.

    02:36 CMV PCR, EBV IGM, EBV PCR, what these all mean? Diagnosis.

    02:43 So make sure that you know what PCR is being used for.

    02:47 Polymerase Chain Reaction (PCR).

    02:49 You're looking for you replication of your viruses.

    02:52 That becomes of outmost importance if your dealing with Viral Hepatitis.

    02:57 You're trying to, as an objective, I am telling you in infectious disease as a criteria, you want to start decreasing the sustained viral replication. The SVRs.


    About the Lecture

    The lecture Other Types of Viral Hepatitis by Carlo Raj, MD is from the course Cirrhosis – Liver Diseases.


    Included Quiz Questions

    1. Immunocompromised state
    2. Multiple sexual partners
    3. Smoking
    4. Alcohol consumption
    5. Working in industry using carbon tetrachloride
    1. No treatment since it usually self-limiting
    2. Antibiotics
    3. Surgery
    4. Anti-viral drugs
    5. Steroids
    1. Jaundice
    2. ALT >5000
    3. Fever
    4. Mental status changes
    5. Detection by HSV PCR

    Author of lecture Other Types of Viral Hepatitis

     Carlo Raj, MD

    Carlo Raj, MD


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