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Gastroenterology > Hepatitis > Flashcards

Flashcards in Hepatitis Deck (40):
1

Chronic hepatitis characterized by circulating autoantibodies (not thought to be part of the pathophysiology) & high levels of serum globulin concentrations

autoimmune hepatitis

2

Treatment for autoimmune hepatitis

corticosteroids. azathioprine 2nd line

3

Genetic disease due to autosomal recessive gene HFE. Most common single gene disorder

hemachromatosis

4

Increased iron load leads to eventual cirrhosis, cardiomyopathy, DM, and hypogonadism

hemochromatosis

5

When do symptoms of hemochromatosis usually present?

age 40 or when iron stores reach 15-40g

6

Classic presentation of hemochromatosis

cutaneous hyperpigmentation w/ diabetes & cirrhosis

7

Gold standard for confirmation of hemochromatosis in addition to elevated serum transferrin saturation and elevated serum ferritin

liver biopsy

8

The mainstay of treatment for hemochromatosis is phlebotomy. What lifestyle modifications should a patient also make?

avoid red meat, Fe vitamins, ETOH, and the handling/eating of raw seafood. Get Hep A&B vaccines

9

Autosomal recessive disease that affects copper metabolism. Organ damage due to copper build up in the liver and brain

Wilson's disease

10

Generally presents between 1st-3rd decades with liver disease, neurologic and psych symptoms

Wilson's Disease

11

Pathognomic for Wilson's disease

kayser-fleischer rings in the eyes

12

Treatment for Wilson's disease

chelation therapy w/ D-penicillamine

13

Can occur within hours of a large alcohol binge & if continues to drink can progress. May have tender hepatomegaly. Transaminases mildly elevated. Can also occur in obese individuals and pregnancy

fatty liver

14

Physical exam may reveal spider angiomas, palmar erythema, gynecomastia, parotid enlargement, testicular atrophy, ascites, encephalopathy

fatty liver

15

Distinguishing feature of transaminases associated with fatty liver disease that is rarely seen in other forms of liver disease

AST: ALT ratio usually greater than 2:0

16

Histology finding associated with fatty liver disease

Mallory bodies

17

Treatment of fatty liver disease

alcohol cessation, glucocorticosteroids for severe cases, possible liver transplant

18

Most common cause of liver failure in the US

drug induced liver injury (DILI)

19

Common group of drugs that induce asymptomatic elevations in liver enzymes without causing disease

statins

20

Most common drugs implicated in DILI in US

acetaminophen and antibiotics

21

Treatment for acetaminophen overdose

Activated charcoal if ingested within 2-3 hours. N-acetylcysteine for severe overdose

22

T/F All patients with liver tenderness and jaundice secondary to acetaminophen should received N-acetylcysteine

true

23

General signs of viral hepatitis on exam

jaundice, RUQ pain, hepatomegaly

24

Viral hepatitis where there is no chronic infection and no documentation of maternal-fetal transmission

hepatitis A

25

Fecal-oral route predominates. Close personal contact (e.g. household contact, sex contact, day care centers). Contaminated food/water
Blood exposure

hepatitis A

26

Serology results with positive IgM antiHAV, what does patient have?

acute hepatitis A

27

Major mode of transmission of Hep B in developed and underdeveloped countries

developed ususally sexual and underdeveloped usually perinatal transmission

28

Postexposure prophylaxis for hep B

first dose of vaccine. Administer HBIG at same time—different site than vaccine

29

Extrahepatic manifestations due to circulating immune complexes include: fever, rash, arthralgias/arthritis, polyarteritis nodosa, glomerular dz

hepatitis B

30

In hepatitis B, appears prior to onset of sx and if resolves becomes undetectable in 4-6 months. Persistance past 6 months indicates chronic infection

Hepatitis B surface antigen (HbsAg)

31

Intracellular antigen in affected hepatocytes. What does the rresence of Anti-HBc of IgM class indicates?

acute HBV infection

32

What does the presence of anti-HBs only indicate?

immunity to HBV by vaccination

33

Secretory protein. Marker of HBV replication and infectivity. occurs early in patients w/ acute infection

Hepatitis B e antigen (HbeAg)

34

Agent of choice for chronic HBV infection (ie those with HBeAg, high serum HBV DNA levels, and active liver disease/elevated LFTs)

Interferon or peginterferon

35

What is the cause for the majority of liver transplants in the US usually caused by IV drug use or sex with IV drug user?

hepatitis C

36

Most common complaint of hepatitis C

fatigue

37

What do you use to assess response to treatment in chronic HCV infection?

sustained HCV RNA negativity

38

Do liver transplants help HCV patients?

NO. a non-infected liver transplanted into an HCV infected patient becomes infected and decreases survival

39

Required for hepatitis D replication

hepatitis B

40

RNA virus. Enterically transmitted, waterborne virus. U.S. cases usually have travel history to endemic area. NO chronic form

hepatitis E