Henderson- Liver Transplant and Hepatitis

Question 1

indications name for liver transplants

Answer 1

MELD 3.0

Question 2

liver tranplant evaluation indications:

Answer 2

MELD 3.0:
low serum albumin
sex

Question 3

special indications for liver tranplant

Answer 3

HCC
portopulmonary HTN
hepatopulmonary syndrome

Question 4

____ was made to hopefully increase allocation for liver transplants to sick patients

Answer 4

MELD 3.0

Question 5

special indication for transplant that deals with cirrhotic liver with tumor present

Answer 5

HCC

Question 6

current criteria for liver transplant for HCC patient

Answer 6

UCSF

Question 7

single lesion </= 6.5 cm
</= 3 nodules w/ large </= 4.5cm
maximal tumor burden </=8 cm
no vascular invasion or extrahepatic invasion

Answer 7

UCSF criteria

Question 8

complication of portal HTN and patient has liver cirrhosis and pulmonary HTN

Answer 8

Porto-pulmonary HTN

Question 9

pulmonary vasodilation (takes O2 longer to travel across membrane)

Answer 9

porto-pulmonary HTN

Question 10

dyspnea (sob)
R ventricle overload

Answer 10

porto-pulmonary HTN

Question 11

screening for porto-pulmonary HTN

Answer 11

echo

Question 12

ECHO and pulse ox
main symptom is dyspnea

Answer 12

porto-pulmonary HTN

Question 13

screening tool for hepatopulmonary syndrome

Answer 13

Pulse ox (and then ABG if <94%)

Question 14

to diagnose hepatopulmonary syndrome

Answer 14

Echo (seeing bubbles from R to L in heart after third cardiac cycle)

Question 15

low MELD
transplantation needed due to gastric compression
liver labs normal

Answer 15

polycystic liver disease

Question 16

autoimmune
recurrent cholangitis

Answer 16

PSC

Question 17

risk for rare cholangiocarcinoma
indication for liver transplant

Answer 17

PSC

Question 18

workup for liver transplant for everyone

Answer 18

cross sectional abd imaging
ECHO w/ bubbles
pulse ox; ABG

Question 19

what age to screen for colon cancer

Answer 19

45

Question 20

what age to screen for prostate cancer (PSA)

Answer 20

> 50

Question 21

ischemic heart disease evaluation for low risk patients

Answer 21

stress test

Question 22

ischemic heart disease for evaluation for high risk patients

Answer 22

heart cath

Question 23

what does a liver transplant recipient have to have

Answer 23

someone to help them

Question 24

RNA virus
acute

Answer 24

Hep A and E

Question 25

DNA virus acute not curable

Answer 25

Hep B

Question 26

RNA virus acute and chronic treat everyone

Answer 26

Hep C

Question 27

incidence of _____ has gone up since COVID

Answer 27

Hep A

Question 28

fecal-oral transmission (food handlers, sexual contact, drug abuse)

Answer 28

Hep A and Hep E

Question 29

presentation for hepatitis

Answer 29

jaundice RUQ pain AST/ALT > 1000 hx

Question 30

super infectious and will be really bad for pregnant or immune compromised patients

Answer 30

Hep A

Question 31

RNA acute patient works on farm (Asia, midwest)

Answer 31

Hep E

Question 32

travel hx important for ___

Answer 32

Hep E

Question 33

___ and ____ severe in pregnant and immunocompromised patients

Answer 33

Hep A and Hep E

Question 34

incorporates host DNA and becomes a part of you (not curable)

Answer 34

Hep B

Question 35

DNA virus acute presentation 10% will develop chronic infection

Answer 35

Hep B

Question 36

40 fold more infectious than HIV PWID (people who inject drugs) blood transfusion screening

Answer 36

Hep B

Question 37

4 diseases where you will see AST/ALT> 1000

Answer 37

viral hepatitis autoimmune hepatitis Tylenol toxicity shock liver

Question 38

dx Hep B

Answer 38

HBsAg +>6 months

Question 39

can you treat Hep B

Answer 39

no, just suppress it

Question 40

treat EVERY patient with this

Answer 40

Hep C

Question 41

estimate what with Hep C patient

Answer 41

fibrosis

Question 42

Screen_____ for Hep C

Answer 42

everyone

Question 43

lives in cytoplasm

Answer 43

HCV

Question 44

lives in nucleus

Answer 44

HBV

Question 45

normal vaginal intercourse is not a risk for this

Answer 45

Hep C

Question 46

extremely sexually transmissible

Answer 46

Hep A, E, B

Question 47

if patient w/ HCV has fibrosis (cirrhosis), what are they at risk for

Answer 47

HCC

Question 48

fibrosis assessment for HCV if you treat patient

Answer 48

Fibroscan

Question 49

antivirals SOFOSBUVIR + LEDIPASVIR

Answer 49

to treat Hep C in 8-12 weeks stop viral genome replication

Question 49

HCV Ab + shows what

Answer 49

person has been exposed to Hep C

Question 50

what shows if patient is infected with Hep C

Answer 50

viral load (SVR)

Question 51

when to test SVR (viral load) after ending treatment for Hep C

Answer 51

12 weeks later

Question 52

SAg+ eAg+ eAb- AST elevated DNA (viral load) 20,000

Answer 52

treat for Hep B

Question 53

SAg + eAg- eAb+ DNA (viral load) 2,000 AST elevated

Answer 53

treat for Hep B

Question 54

SAg + eAg+ eAb- HBV DNA >100 AST normal

Answer 54

dont treat for Heb B

Question 55

SAg+ eAg- eAb+ HBV DNA >100 AST normal

Answer 55

dont treat for Hep B

Question 56

viral load of 200,000 in pregnant woman

Answer 56

treat for Hep B

Question 57

this antibody appears after person has cleared Hep B infection

Answer 57

HBsAb