It’s is a very common question in community medicine, if you had an option to choose a roommate, who had Mumps or Hepatitis, which one would you choose?
Doesn’t it seem like a beauty pageant contest question? Usually, analytical questions are skipped, but somehow I reached that level. Cut down the beauty, it did not even seem like a contest, it was matter of life or death. I am usually at my worst form before and during the exam (everybody is).
I quickly answered the question “Hepatitis”. Verdict: Pass. She asked me further, in-depth questions. This is how a typical oral exam looks like. You have to react very fast and if the answer is right you progress to more questions and they actually dig all the answers from you.
Hepatitis is the inflammation of the liver. Whenever I add a “itis” behind any term, you are supposed to assume that it means inflammation. If I asked you to name 10 diseases, you can easily answer by adding “itis ” to the end of the organ involved. Just for instance: Appendix – Appendicitis, Stomach – Gastritis. Lungs – Pneumonia, Brain – Encephalitis, Meninges –Meningitis.etc
Liver is one the heaviest organ is the body which is located the right upper hypochondrium (If you follow my blog posts, you should know by now that the stomach area in divided into 9 areas). Can you feel it? Usually it’s not palpable but when it gets enlarged you can feel the lower border of the liver.
Liver’s major function is to metabolize, everything that you eat, the minute remains of food, like carbohydrate, protein, fat is further broken up into minor components. Besides that it secretes some clotting factors II,VII,IX,X ( I can forget my phone number , but I can never forget these clotting factors , it’s a good question for the oral ), plus it stores some vitamins and it secretes hormones and bile.
Hepatitis is of three basic types. Pre-Hepatic, Hepatic and Post- Hepatic.
Pre –Hepatic: as the name indicates that something happens before the liver. It’s mostly due to auto immune diseases. It occurs due to increased Red Blood Cells destruction.
Hepatic: It’s due to the liver; the problem lies in the liver cells, parenchyma cells, if you want to be more accurate. They get disturbed during Viral Infections caused by Hepatitis A,B,C,D,E,G. This is a very common cause of Hepatitis. In a developing country like ours, most patients come up with Hep A.
Post Hepatic: You guys know that the liver secretes Bile, and is connected with the gall bladder right? So anywhere in the passage of the bile to the gallbladder, if obstruction takes place, this hepatitis takes place. Obstruction can occur due to a stone formation or due to ca of the head of the pancreas. ( Ca =Cancer )
Getting bored with the details?
I was taking a history of a patient, who just returned from a UN mission; there he was given blood transfusion after suffering from Malaria. 6 months later he is a known case of Chronic Hepatitis, He suffers from Hepatitis B infection.
Hepatitis A, E is food borne; it is transmitted from any contaminated food or drink
The rest of the hepatitis is due to infected blood transfusion (Parental route), men who have sex with men, from a mother to a fetus, from needle prick, tattoo prick.
Please stay tuned for more Hepatitis related posts! This much for today!