Autoimmune Hepatitis Flashcards

1
Q

how many types of autoimmune hepatitis are there?

A

3

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2
Q

what are the antibodies for each type of autoimmune hepatitis.

A

Type 1. Anti-nuclear antibodies &/or anti-smooth muscle antibodies

Type 2. Anti-liver/kidney microsomal type 1 antibodies

Type 3. Soluble liver-kidney antigen

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3
Q

which type of autoimmune hepatitis affects kids only?

A

type 2

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4
Q

which type of autoimmune hepatitis affects adults only?

A

type 3

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5
Q

which type of autoimmune hepatitis affects kids & adults ?

A

type 1

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6
Q

which gender is a risk factor for autoimmune hepatitis?

A

female

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7
Q

what is the cause?

A

unknown

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8
Q

antibodies for type 1 autoimmune hepatitis?

A

Anti-nuclear antibodies &/or anti-smooth muscle antibodies

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9
Q

antibodies for type 2 autoimmune hepatitis?

A

Anti-liver/kidney microsomal type 1 antibodies (LKM1)

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10
Q

antibodies for type 3 autoimmune hepatitis?

A

Soluble liver-kidney antigen

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11
Q

most common sign for autoimmune hepatitis?

A

hepatomegaly

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12
Q

pt with autoimmune hepatitis has an acute attack.

what are the three typical symptoms&signs?

A

fever
jaundice
RUQ tenderness

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13
Q

what commonly happens to menstruation?

A

amenorrhoea

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14
Q

which main 2 bloods do you order?

-2

A

LFTs

antibody test

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15
Q

results on LFT?

-3

A

↑↑↑AST
↑IgG
↑ALP

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16
Q

which investigation can be used to 100% confirm diagnosis?

A

liver biopsy

17
Q

what is the diagnostic criteria?

A

need to rule out any other cause via lots of bloods + biopsy

18
Q

why is a positive antibody test not enough to diagnose autoimmune hepatitis?

A

some other diseases also have these antibodies raised

19
Q

pt is asymptomatic.

what is 1st line Mx?

A

observe only

20
Q

pt is symptomatic.

what is 1st line Mx?

  • drug group (1)
  • drug class (2)
A

immunosuppress

corticosteroids or azathioprine

21
Q

what group of drug is azathioprine?

A

immunosuppressant

22
Q

what is 2nd line Mx in refractory cases with end-stage liver disease and drugs have not worked?

A

liver transplant

23
Q

pt has autoimmune hepatitis?

there is a sharp increase in ALP.

what disease does this suggest?
-2

this disease is a complication of what?

A

primary sclerosing cholangitis or hepatocellular carcinoma

liver cirrhosis

24
Q

chronic inflammation in autoimmune hepatitis which eventually lead to what hepatic morphology?

A

cirrhosis