case 5 - PBL

Question 1

how are obesity and hepatitis linked

Answer 1

obesity is an inflammatory condition, resulting in an abnormal immune response to therapy.
The second mechanism hypothesises that obesity can cause insulin resistance and hepatic steatosis which leads to fibrosis, resulting in direct or indirect interference with the effect of interferon oh hepatocytes
The third mechanism hypothesises that obesity results in decreased bioavailability of peginterferon alpha.

Question 2

what happens in mechanism one in relation to antiviral therapy

Answer 2

obesity is hypothesised as an inflammatory condition, resulting in abnormal immune response to therapy

Question 3

what happens in mechanism two in relation to antiviral therapy

Answer 3

In mechanism 2, obesity is hypothesised to cause insulin resistance and hepatic steatosis, leading to steatohepatitis and hepatic fibrosis, which can interfere directly or indirectly with the effect of IFN on hepatocytes.

Question 4

what happens in mechanism three in relation to antiviral therapy

Answer 4

In mechanism 3, obesity is hypothesised to decrease the bioavailability of peginterferon alpha

Question 5

what happens to babies born to mothers with hep b

Answer 5

Babies born to mothers with hepatitis B are given additional vaccinations at birth, 4 weeks and 1 year to reduce the risk of them getting the infection

Question 6

when do adults get the hep b vaccine

Answer 6

travelling to a high risk country
Liver or kidney disease
You have HIV
Your job puts you at risk of infection

Question 7

what does co amoxiclav contain

Answer 7

is a combination antibiotic containing amoxicillin trihydrate, a beta-lactam antibiotic with the potent beta-lactamase inhibitor clavulanic acid

Question 8

what is the pattern of liver enzyme elevations in co-amoxiclav induced liver injury

Answer 8

In these cases, the pattern of liver enzyme elevations is typically cholestatic with marked elevations in alkaline phosphatase and gamma glutamyl transpeptidase
In children, the pattern of serum enzyme elevations is much more likely to be hepatocellular

Question 9

what is the liver injury due to

Answer 9

The liver injury appears to be due to the clavulanate, rather than the amoxicillin