{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Board Pearls","title":"Chapter 18, Ep 1 of 3: Acute Viral Hepatitis and the Fecal-Oral Viruses","html":"","width":"100%","height":180,"duration":767,"description":"Episode one of the Viral Hepatitis chapter builds the acute-hepatitis framework and covers the two fecal-oral viruses, hepatitis A and hepatitis E. The organizing idea: acute viral hepatitis looks the same no matter which virus caused it, so you read the virus off the serology, not the symptoms. It walks the four clinical phases, the four-test acute panel with its two named traps, and then hepatitis A as a post-exposure-prophylaxis decision that splits by age and host. Hepatitis E closes it with its two high-yield scenarios: twenty to thirty percent mortality in third-trimester pregnancy and chronic infection in the immunocompromised.\n \nTopics covered\n\nThe acute-hepatitis mechanism and its four phases\nThe four-test first-line serologic panel\nSerology interpretation rules and two named traps\nDifferential, alarm features, and treatment by virus\nHepatitis A course, risk factors, and atypical variants\nHepatitis A vaccine and post-exposure prophylaxis\nHepatitis E genotypes and when to test\nHepatitis E in pregnancy and chronic infection with ribavirin\n \n \nKey decisions\n\nThe first move on any acute hepatitis stem is the serologic panel, not the history, because the clinical phases are identical across viruses.\nThe first-line acute panel is four tests, hepatitis B surface antigen, hepatitis B core IgM, hepatitis C antibody with reflex to RNA, and hepatitis A IgM, adding hepatitis E IgM in the returning traveler or when the panel is negative.\nSurface antigen positive with core IgM positive is acute hepatitis B, while surface antigen positive with core IgM negative but total core positive is chronic hepatitis B.\nA high-suspicion hepatitis C patient with a negative antibody is not cleared, because the antibody lags viremia by a couple of months, so the RNA closes the question.\nPost-exposure prophylaxis splits by host: immunocompetent persons aged twelve months to forty get a single vaccine dose within two weeks, while those over forty, the immunocompromised, chronic liver...","thumbnail_url":"https://img.transistorcdn.com/-FuAdDBcPDLhEoUmroZKtOBRvuBn_FHPpYlh41hOnU4/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9iNzlh/ZTU4Y2MzNWExMjQ5/MjA5OWMwMmI3ZTk5/NGFiZS5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}