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Liver diseases 3 rd year (2)


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Oral Diagnosis I
Third Year

Published in: Health & Medicine
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Liver diseases 3 rd year (2)

  1. 1. Liver Diseases Dr. Suresh. C.S. BDS; MDS; MDSc ( UK )
  2. 2. Hepatitis Infectious Non-infectious -Viral. -Secondary Syphilis. -Tuberculosis. -Alcohol. -Halothane. -Ketokonazole. example example
  3. 3. Viral Hepatitis A, B, C, D, and E Hepatitis A: Infectious Hepatitis. RNA-V Hepatitis B: Serum Hepatitis. DNA-V Hepatitis C: Non-A non-B Hepatitis [NANB]. RNA-V Hepatitis D: Delta Hepatitis. RNA-V Hepatitis E: RNA-V
  4. 4. Hepatitis A “Infectious Hepatitis” Incidence: 150,000 people in the U.S. are infected each year by hepatitis A. High risk geographic areas are Middle East, South America, Eastern Europe, Central America, Africa and Southeast Asia. IP: 15 – 50 days. Transmission: is usually by drinking water or eating contaminated food. Direct contact with an infected person, as kissing.
  5. 5. Signs and Symptoms: A person infected with hepatitis A may not have any symptoms. However, in those who do have symptoms, they resemble the flu. These symptoms include: -Fatigue, nausea, vomiting. -Pain in the liver area, -Dark urine or light colored stools and fever. -Liver function tests are elevated, with many adults developing jaundice. Most people recover within six months. Hepatitis A “Infectious Hepatitis”
  6. 6. Hepatitis B “Serum Hepatitis” Transmission: This disease is more infectious than AIDS and is transmitted through infected blood and other body fluids (seminal fluid, vaginal secretions, breast milk, tears, saliva and open sores). IP: 45 – 180 days. However, it is not spread by casual contact such as: -Holding hands. -Kissing on the cheek or dry lip kissing. -Eating food prepared by a carrier. -Visiting an infected person. -Playing with a child who is a carrier. -Sneezing or coughing.
  7. 7. Signs and Symptoms: Most people who get hepatitis B have no recognizable signs or symptoms. Some People Have Symptoms That Mimic The Flu: loss of appetite. nausea and vomiting. Fever. weakness, tiredness, lasting weeks or even months. abdominal pain. dark urine. yellowing skin and eyes (jaundice). Hepatitis B “Serum Hepatitis”
  8. 8. Hepatitis C “NANB” The hepatitis C virus was identified and described in 1989, and in 1990 a hepatitis C antibody test (anti-HCV). There are 3.5 million Americans chronically infected with HCV. IP: 14 – 180 days. Transmission: HCV can be transmitted through blood transfusions. Other individuals who may come in contact with infected blood, instruments, or needles, such as IV drug users, health care workers, dentists or laboratory technicians are also at risk.
  9. 9. Hepatitis D “Delta Hepatitis” Hepatitis D occur only as a coinfection with hepatitis B or as a superinfection in carrier of hepatitis B. Transmission is the same of hepatitis B, however, signs and symptoms frequently are more severe. IP: 15-150 days.
  10. 10. Hepatitis E Resembles hepatitis A. Transmitted via fecal-oral contamination. Common in India, Northern Africa, southeast Asia and Mexico. IP: 15 – 60 days with viremia. Hepatitis Non A-E Unknown viruses and unknown etiology. Hepatitis F and hepatitis G were linked to this type of hepatitis
  11. 11. HBV-Ag: hepatitis B virus antigen test. Anti-HCV: Antibody to hepatitis C virus. ALT-Liver enzyme released from liver cells that are injured, eg. by virus, alcohol, fat, drug, etc. RIBA-2 - Supplemental test to detect antibody to hepatitis C virus. HCV-RNA test by polymerase chain reaction (PCR) determines whether the virus is multiplying. Laboratory Findings
  12. 12. Medical Managements - Active immunization “vaccines”. -Passive immunization “antibodies” Must be given with interval of 5 months from MMR prevention Treatment -Treatment of viremia. -Diet. -Interferon (IFN) alpha-2b.
  13. 13. Dental Managements - History. - Clinical examination. - Consultation with physician. - Minimizing of drugs metabolized by liver such as: [Lidocaine, Aspirin, Ibuprofen, Diazepam, Ampicillin, Metronidazole, Tetracycline]. - Bleeding time, thrombin time, and prothrombin time should be consider for surgical procedures. contamination Patient DentistInstrumentsPatient
  14. 14. Non-Infectious Diseases Alcoholic Liver Disease
  15. 15. Alcoholic Liver Disease Hepatitis Cirrhosis Malnutrition and anemias 2 1 3
  16. 16. Alcoholic Liver Disease Signs and Symptoms Psychiatric problems. Nausea. Vomiting. Anorexia. Weight loss. Fever. Hepatomegaly. Hepatic coma General Oral Enlargement of parotid G. Xerostomia. Bad oral hygiene. Petechiae and ecchymoses. Jaundiced oral mucosa. Fungal infections. Bruxism. Alcohol breath odor.
  17. 17. Alcoholic Liver Disease Medical managements - Identification of the case. - Withdrawal from alcohol. - Mange the CNS depression.
  18. 18. Dental managements Alcoholic Liver Disease Screening for alcohol risk. Providing alcohol prevention information. Take in consideration: [Risk of infection spread, bleeding tendencies, metabolism of certain drugs].