Flashcards in EXAM #2: VIRAL HEPATITIS Deck (52)
Describe the histologic appearance of hepatitis.
- Blue= bad, lymphocytes
- Pink= good
What are the complications of hepatitis?
2) Hepatocellular carcinoma
How does cirrhosis appear histologically?
- Fibrosis (blue) with islands of normal liver tissue (pink)
- Regenerative nodules
What are the signs and symptoms of hepatitis?
- Majority of patients are asymptomatic
- Some with acute hepatitis have vague flu-like symptoms
What is self-limiting hepatitis?
Hepatitis that is self-resolving
What is fulminant hepatitis?
Overwhelming liver inflammation that leads to liver failure
List the etiologies of hepatitis.
2) Immune related
What are the immune related causes of hepatitis?
1) PBC--primary biliary cirrhosis
2) Primary Sclerosing Cholangitis (complication of UC)
What are the self-limited causes of viral hepatitis?
HAV and HEV
What patient population is autoimmune hepatitis most common in?
Middle aged females
What antibodies are positive in autoimmune hepatitis?
1) Antinuclear antibody (ANA)
2) Anti-smooth muscle antibody (ASMA)
How is autoimmune hepatitis treated?
What is the classic histologic finding in autoimmune hepatitis?
Severe inflammation of the portal triads
What is Primary Biliary Cirrhosis?
Immune mediated destruction of the BILE CANALICULAE
What antibody is associated with PBC?
Anti-mitochondrial antibody (AMA)
What are patients with PBC at risk for?
What is the treatment for PBC?
Urso (bile acid supplement)
What is PSC?
Immune mediated destruction of the large bile ducts leading to stricture/ obstructive jaundice
What disease is PSC strongly associated with?
How is PSC treated?
Currently there is no effective therapy
What is the most common cause of non-hepatitis virus infection causing hepatitis?
What is unique about the liver reaction to Isoniazid (INH)?
- Undetected hepatitis from INH can lead to cirrhosis
- Mandated that INH administration is followed with LFT measuring
What four chemicals will cause a dose-dependent liver destruction?
2) Amanita Phalloides (mushroom)
3) White phosphorus
4) Carbon Tetrachloride
What type of virus is HAV?
What is HAV infection associated with?
Traveling is considered classic
- South America
- SE Asia
*****HOWEVER, in the US, DAYCARE is the most common*****
How is HAV transmitted? What are the unusual modes of transmission?
- Homosexual activity
What lab test is associated with symptomatic HAV infection?
ALT elevation is associated with symptomatic HAV
What are the worrisome variants of HAV infection?
1) Cholestatic hepatitis
2) Relapsing hepatitis
3) Fulminant hepatitis
What type of virus is HBV?