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Internal Medicine 1: Hepatology > Acute And Chronic Hepatitis > Flashcards

Acute And Chronic Hepatitis Flashcards

1
Q

What is the hepatic lobule composed of?

A

Hepatocytes radiating outwards from the central vein, to the portal triad

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2
Q

What does the portal triad contain?

A

Portal vein, hepatic artery and bile duct

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3
Q

What is the Functional unit of the liver?

A

The Hepatic acinus

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4
Q

The hepatic acinus has 3 zones, the first zone has which type of hepatocytes?

A

Periportal, they are metabolically active

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5
Q

Zone 2 has what type of hepatocytes?

A

Midzonal, they’re of regenerative potential

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6
Q

Zone 3 has what type of hepatocytes?

A

Centrilobular, they receive the lowest oxygen and nutrient supply

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7
Q

What’s the duration of acute hepatitis vs chronic?

A

Chronic if 6 months or more

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8
Q

What damage can chronic hepatitis cause?

A

Liver fibrosis, cirrhosis, or hepatocellular carcinoma

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9
Q

Most common cause of acute hepatitis?

A

Viral infection

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10
Q

Acute viral hepatitis is caused by 2 types of viruses, what are they?

A

Hepatotropic and non-hepatotropic

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11
Q

Difference between hepatotropic and non hepatotropic?

A

Hepatotropic infect the liver cells only

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12
Q

What is the most common cause of acute viral hepatitis?

A

Hepatotropic

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13
Q

All hepatotropic viruses are RNA viruses except…?

A

Hepatitis B

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14
Q

Hepatitis A and E virus are transmitted via?

A

Enterically via feco-oral route

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15
Q

Hepatitis B,C,D are transmitted via?

A

Parentally

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16
Q

What is the mechanism of hepatocytes injury?

A

immune-mediated

17
Q

How does yhe hepatocyte injury in HBV and C become chronic?

A

The virus specific T-cells are exhausted, thus allowing the virus to exist indefinitely

18
Q

What is histologically seen with the hepatitis?

A

Hepatocytic swelling, focal spotty necrosis

19
Q

Explain the histological feature called bridging

A

When the necrosis extends from zone 3 to 1, the reticulum collapses and leaves connective tissue septa

20
Q

What is the Clinical presentation of acute hepatitis?

A

Icteric attack

21
Q

What is the Pre icteric phase?

A

The patients feels very unwell a few days or weeks even before the icteric phase

22
Q

What does the icteric phase present as?

A

Jaundice, darkening of urine and lightening of stools

23
Q

What is prolonged cholestasis commonly associated with?

A

HAV and HEV

24
Q

What biomarker increases to indicate acute hepatitis?

A

Serum aminotransferases

25
Q

What are the values that serum amino transferases reach in hepatitis?

A

500 and even 1000U/L

26
Q

What causes chronic hepatitis?

A

HCV causes 60-70% of cases, with 75% becoming chronic

27
Q

What do we order to diagnose chronic hepatitis?

A

Labs and a liver biopsy

28
Q

What is the gold standard for chronic hepatitis diagnosis?

A

Liver biopsy

Internal Medicine 1: Hepatology (7 decks)

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