Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Prep > Hepatitis > Flashcards

Hepatitis Flashcards

1
Q

Which types of Hep can be come chronic?

A

B, C, D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hepatitis that is only acute

A

A and E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Fulminant Hepatitis means…

A

Acute Liver failure in the setting of Hepatitis

Encephalopathy, Coagulopathy, Hepatomegaly, Jaundice, edema, ascites, asterixis, hyperreflexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

AST and ALT values of Acute and Chronic Hep

A

Acute: >500
Chronic: <500

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can cause Fulminant Hepatitis? (Acute liver failure)

A

Acetaminophen toxicity (tylenol)
Viral hep
Reye syndrome- kids given ASA after viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Reye syndrome

A

when you give ASA to a child after viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tx of Fulminant Hepatitis

A

IVF
Mannitol (if ICP elevation)
Blood products of platelets
Definitive: liver transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hep A- acute always

A

Fecal-oral, International travel
May be A-sx, or SPIKING FEVER

Tx: none, self limiting
Prevent: Sanitation and handwashing
If you’ve been exposed: HAV vaccine. If you are immunocomp or have chronic liver dz, get HAV and HAV immunoglobulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hep E is always acute, but what is the worry?

A

Highest mortality due to Fulminant Hep during pregnancy
(esp during 3rd trimester)

Transmission: mother to child, fecal-oral, blood transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does Hep D need in order to be present?

A

Hep B!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hep D details

A

Transmission: blood
Tx: none FDA approved, but can try Interferon alpha if chronic, and Liver transplant as definitive

Prevention: get the Hep B vaccine!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hep C is known for

A 
becoming CHRONIC "C for Chronic"
Most common infectious cause of:
-Chronic liver dz
-Cirrhosis
-Liver transplant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Transmission of Hep C is usually

A

IVDU

or needlestick injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long does it take for Hep C antibodies to become positive?

A

within 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is Hep C curable?

A

thankfully, YES

> 95% cure rate within 12 weeks of oral therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The type of Hep with all the crazy antibodies

A

Hep B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx for Hep B

A

Supportive is mainstay, most pts will not advance to Chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tx for Chronic hep B

A

If pt has persistent or severe sx, marked jaundice, etc

Antiviral therapy: Entecavir, Tenofovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hep B vaccine

A

Infant: birth, 2 mo, 6-18 mo (3 doses)

Adult if not previously vaccinated: 0, 1, and 6 mo (3 doses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How many doses of Hep B vaccine do you normally get?

A

3 doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Contra to Hep B vaccine

A

Baker’s yeast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Remember the order of antibody initiation

A

“My Grandma…..”

M, then G

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hep B antibodies

A

if IgM= acute

if IgG= chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

If the surface antigen is present,

A

either have positive Acute or Chronic Hep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

3 step approach to interpreting Heb B antibodies:

Surface antigen
Core ANTIBODY
Surface ANTIBODY

A

1) look at Surface antigen- if it’s positive, then you have Hep B
2) look at Core antibody- if its IgM: acute. if it’s IgG: chronic.
3) if Surface antigen is negative- then you either have resolved infection OR immunity from vaccination. the anti-hBs will be positive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

If you have negative HBsAg (meaning no active infection) but positive anti-HBs, how can you tell if the immunity is from a Vaccination or past Infection that’s healed?

A

look at the core igG antibody (the 2nd one to come into play)

if IgG is positive: recovery from past infection
if IgG is negative and surface anti-HBs was the only thing positive: Vaccination was given

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Steps of antibodies to look at with Hep B

A 
Surface ANTIGEN (HBsAg)
Core antiBODY (anti-HBc)
Surface antiBODY (anti-HBs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

If liver CA is due to hepatitis, what types is it going to be from?

A

Hep B or Hep C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Tx of Liver CA

A

Surgical resection if confined to a lobe and not assoc w/ Cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Most common cause of Portal HTN in children

A

Hepatic Vein Obstruction (Budd-Chiari syndrome)

primary: liver vein clot
secondary: liver vein or inferior vena cava occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Cirrhosis

A

Irreversible fibrosis

Most common cause: Hep C!! and then Alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

PE sign of Hepatic Encephalopathy

A

Confusion and Lethargy (inc ammonia levels in the brain)

Asterixis- flapping wrist tremor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Tx of Liver Cirrhosis

A

Avoid alc and Hepatotoxic meds, weight reduction
Hep A and Hep B vaccine
Liver transplant- definitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Tx of Encephalopathy

A

Lactulose or Rifamixin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Tx of Ascites

A

Spironolactone

Furosemide (lasix)

36
Q

Tx of Pruritis associated with Cirrhosis

A

Cholestyramine- a bile acid sequestrant, reduces bile salts in the skin, leading to less irritation from the bile salts

37
Q

If you have Liver cirrhosis, what screening do you need to have?

A

LIVER CA surveillance-

UltraSound every 6 months

38
Q

Why can Cirrhosis cause itching of the skin?

A

Bile salts in the skin

tx: cholestyramine

39
Q

Spontaneous Bacterial Peritonitis

a serious complication of Liver Cirrhosis

A 
Infection of the Ascitic fluid
E.Coli
PE: Shifting dullness, Fluid wave
Dx: Paracentesis 
Tx: Cefotaxime or Ceftriaxone (Rocephin)

Proph: need lifelong Bactrim

40
Q

Shifting dullness, Fluid wave

Tx: Ceftriaxone
Proph: Bactrim

what is this condition

A

Spontaneous Bacterial Peritonitis
(a complication of Liver Cirrhosis)

Sx: Fever, chills, abd pain, diarrhea. NOT LOOKIN SO HOT

41
Q

Primary Biliary Cholangitis

A

Autoimmune
Intraliver small bile ducts disorder, leading to decreased bile salt excretion, Cirrhosis, and ESRD

Older women (30-60)
\+ AMA

Fatigue is often first symptom

42
Q

Women like to watch PBC channel

A

Women, autoimmune
age 30-60
Fatigue, pruritis
+ AMA

Tx: Ursodeoxycholic acid

43
Q

Primary Sclerosing Cholangitis -PSC

A

younger men
associated with ULCERATIVE COLITIS

Fibrosis of intra AND extra hepatic biliary ducts
+ P-ANCA
Beaded appearance of biliary ducts on MRCP,ERCP

44
Q

Beaded appearance of biliary ducts (bc of fibrosis and narrowing)

younger men

+P-ANCA

A

PSC- Primary Sclerosing Cholangitis

pay attention to middle word- SCLEROSING tells us about fibrosis aspect of dz

45
Q

Copper accumulation

Keyser Fischer rings on eye exam

A

Wilson disease!!!

46
Q

Other sx of Wilson disease- can affect many parts of the body

A

Dysarthria, Psychosis, Hallucinations, Arthralgias

47
Q

What causes Wilson dz?

A

GENETIC DISORDER- Rare autosomal recessive

copper accumulates in the brain, liver, kidney, joints, cornea
EVERYWHERE

48
Q

Tx for Wilson dz

A

Copper chelating agents- Trientine or D- Penicallime and B6

49
Q

Most common type of hernia

A

Indirect Hernia

protrusion at the internal inguinal ring, into the tunnel

50
Q

Hesselbach’s triangle “RIP”

A

Rectus abdominis
Inferior epigastric vessels
Inguinal ligament

51
Q

Femoral hernias are more commonly seen in Men or Women?

A

Women

52
Q

Diet recommended for diarrhea

Bland low residue

A

Crackers, boiled veggies, yogurt, soup

B: banana
R: rice
A: applesauce
T: toast

53
Q

Noravirus

“Nora is in her 20s and she is a bish”

A

Fecal-oral, contaminated food/water

CRUISESHIP and restaurants
lasts 2-3 days
Vomiting is the most dominant sx

54
Q

Rotavirus

A

Kiddos
Most common in unimmunized kids b/w 6 mo-2 yo
fecal- oral transmission

Vomiting, diarrhea, and fever

55
Q

Two most common types of Non-infectious diarrha

A

Noravirus (adults)

Rotavirus (kiddos)

56
Q

Staph Aureus gastroenteritis

A

short incubation within 6 hours

Food is the cause: dairy, mayo, meat, eggs, salad

57
Q

Bacillus cereus

A

short incubation within 6 hours

source: Fried rice

58
Q

Traveler’s diarrhea

A

Enterotoxigenic E. Coli

contaminated food and water

59
Q

Copious watery diarrhea “Rice water stools”

“fishy odor”

A

Vibrio cholerae

Tx: oral rehydration and electrolyte.
Abx: Tetracyclines if needed

60
Q

Most common cause of death from seafood consumption in the US

A

V. Vulnificus

can cause necrotizing fasciitis, cellulitis, and gastroenteritis

61
Q

C-Diff is non-invasive, non bloody diarrhea

BUT the complications of it are:

A

Pseudomembranous colitis
Bowel perforation
TOXIC MEGACOLON

62
Q

what type of bacteria is C-Diff

A

Spore forming

Gram (+) anaerobic

63
Q

Types of Invasive diarrhea

A 
Yersinea 
Campylobacter enteritis
Enterohemorrhagic E. Coli
Typhoid
Nontyphoidal Salmonella
Shigellosis
64
Q

Most common cause of bacterial enteritis in the US

A

Campylobacter Enteritis

C. Jejuni, associated with Guillian Barre syndrome

65
Q

C. Jejuni

A

Raw/undercooked CHICKEN

Fever, crampy periumbilical abd pain

Tx: Azithromycin

66
Q

Enterohemorrhagic E. Coli

most common in CHILDREN and eldery
Do we treat with abx?

A

NOT IN CHILDREN

d/t increased incidence of HUS- Hemolytic Uremic Syndrome

67
Q

Typhoid fever YIKES

Tx: FluoroQ (Ciprofloxacin, Ofloxacin)

A

Travel to areas w poor sanitation

HA, intractable fever, chills, abd pain
“pea soup” green diarrhea

Fever w bradycardia
Rose spot rash
Hepatosplenomegaly!!, GI bleeding, dehydration, delirium

68
Q

Non typhoidal salmonella

A

most common cause of foodborne disease in US- chicken, eggs, REPTILES

Tx is supportive unless severe, then give FluroQ

69
Q

Explosive watery diarrhea that progresses to Mucoid and blood
Highly virulent

Leukemoid reaction >50,000

A

Shigellosis!!!

highest risk: children at daycare <5 yo

70
Q

In general, what class of Abx are often used in treating Invasive diarrhea if the diarrhea is severe enough?

A

FluoroQuinolones

71
Q

“Backpacker’s diarrhea” / Beaver fever
Greasy, foul smelling diarrhea

Will see trophozoites or cysts on stool exam

A

Giardia Lamblia

Tx: Metronidazole

72
Q

Amebiasis - E. Histolytic is associated with what complication

A

Liver abscess- fever, RUQ pain, anorexia

Tx: Metronizadole + Tinidazole + intraluminal antiparasitic –> then Chloroquine

may need drainage also if no response to meds

73
Q

Most common cause of SBO

A

post surgical adhesions

74
Q

Most common cause of LBO

A

CA

75
Q

4 clinical sx associated with SBO

A

Crampy abd pain, Distention, Vomiting, Obstipation (no gas)

76
Q

Bowel sounds indicative of SBO on physical exam

A

High pitched tinkles

Visible peristalsis on early obstruction

77
Q

Tx for SBO (as long as non-strangulated)

A

NPO, bowel rest
IVF
Bowel decompression with NG suction

78
Q

Acute Cholecystitis

A

obstruction of CYSTIC DUCT by gallstones

RUQ pain, worse w fatty foods/large meals

Fever, Murphys sign, Boas sign (R shoulder, subscap)

US test of choice, but HIDA scan most accurate

79
Q

Tx for Acute Cholecystitis

obstruction of cystic ducts

A

NPO, IVF, Abx- Ceftriaxone and Metro

Then Removal of gallbladder!

80
Q

Acute Acalculous Cholecystisi

A

cause is NOT gallstones, but rather Neco-inflammatory disease

Gallbladder stasis and ischemia
Risk Factor: critically ill patients
Sx: Fever, jaundice, sepsis, vague abd pain

81
Q

Acute Ascending CHOLANGITIS

A

Obstruction of the WHOLE COMMON BILE DUCT

Charcot’s triad: Fever, RUQ pain, Jaundice

82
Q

Tx for Acute Asc Cholangitis

A

IV abx, make pt stable
ERCP to remove stone
Then, ultimately remove the Gallbladder

83
Q

What is the diff b/w Cholelithiasis and Choledocholithiasis?

A

Cholelithiasis: stone in the gallbladder without inflammation

Docholithiasis: stone in the COMMON BILE DUCT (more serious bc can lead to cholestasis and blockage) Jaundice.

84
Q

Why is a baby jaundice?

A

elevated plasma bilirubin

85
Q

Jaundice is considered physiologic on days

A

3-5, but if it persists beyond that, can lead to –> Kernicterus (cerebral dysfx and encephalopathy)

86
Q

Kernicterus occurs bc there is bilirubin deposition in

A

the brain tissue, leading to:

  • seizures
  • lethargy
  • irritable
  • hearing loss
  • mental developmental delay

Bilirubin >20

87
Q

Constipation is considered how many stools per week?

A

<2 per week

Clinical Prep (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions