Hepatitis and Cirrhosis CIS - Unrein Flashcards Preview

Year2 GI Exam II > Hepatitis and Cirrhosis CIS - Unrein > Flashcards

Flashcards in Hepatitis and Cirrhosis CIS - Unrein Deck (62)
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1

Case 21yo F jaundice, icterus, resting tremor

dark circles irises of eyes

AST and ALT elevated
bilirubin elevated

wilsons disease

2

primary biliary cirrhosis

middle aged females

anti-mitochondrial antibody**

alk phos and cholesterol elevated

3

anti-mito Ab

primary biliary cirrhosis

4

primary sclerosing cholangitis

males age 20-50yo
with ulcerative colitis

5

wilsons disease

auto recessive
kayser fleischer rings
parkinson like tremor
alk phos low

6

Hep A

fecal oral

7

Hep B

blood, body fluid, tissue

8

test for wilsons disease

best test - 24 hour urine copper**

ceruloplasmin - acute phase reactant - so not specific

9

55yo M abdominal ascites, edema, jaundice
-US - small nodular liver
-EKG cardiomyopathy
-IV drug use
-heavy alcohol
-AST ALT elevated slightly
-INR elevated

-HBsAg - positive
-Anti-HBs - negative
-Anti-HBc - positive
-ANti-HBe - positive
-Anti-HCV - negative

ascites total protein high
SAAG low

Metastatic hepatocellular cancer**

serum albumin gradient

10

serum ascitic albumin gradient

SAAG
serum albumin - ascites albumin

correlates with sinusoidal pressure and is function of oncotic-hydrostatic balance

cirrhosis - high SAAG high ascites total protein low

malignant ascites - SAAG low ascites total protein high

cardiac ascites - SAAG high and ascites total protein high

11

SAAG low
ascites total protein high

malignant ascites

12

SAAG high
ascites total protein low

cirrhosis

13

SAAG high
ascites total protein high

cardiac ascites

14

52yo F 6 pack beer per day, injection narcotics, no jaundice, no abdomen pain

nodular liver edge and palpable spleen tip

AST and ALT elevated
alk phos elevated
anti smooth m Ab - 1:640

autoimmune hepatitis

15

autoimmune hepatitis

diagnosis of exclusion
-rule out viral hepatitis

fulminant liver enzyme elevation

perimenopausal women

16

anti smooth m Ab

autoimmune hepatitis

17

case 18yo F jaundice and icterus, no vaccines, IV injection

diarrhea after eating - cafeteria lady Hep A

ALT AST very elevated
total bilirubin elevated

Anti HepA - positive
HBsAg - positive (active disease)
Anti-HBsAg - negative
IgM Anti-HBc - positive (acute) - chronic is IgG
HCV RNA - negative
Anti-HDV - positive

18

HBsAg

peak of Hep B disease

19

Anti-HBsAg

doesn't rise until illness is over

20

Anti-HBc IgM

just before onset of symptoms

21

HCV RNA

detectable 1-3 weeks after infection

unless this persists as chronic infection

22

Hep D

super infection in chronic carrier state or co-infection with Hep B

surface Ag of Hep B required for Hep D to replicate

23

25yo F itching bad, 27 weeks pregnant, prenatal vits, icteric eyes

Alk phos elevated
bilirubin elevated

intrahepatic cholestasis of pregnancy

24

intraheptic cholestasis of pregnancy

2nd or 3rd trimester

mild elevation of bilirubin and alk phos

25

hyperemesis gravidarum

unrelenting nausea and vomiting that is 1st trimester disorder

resolved by week 16

elevated transaminases

no itching or cholestasis

26

HELLP

hemolysis, elevated liver enzymes, low platelets

left threatening complication of pregnancy in 3rd trimester and requires urgent delivery

27

acute fatty liver of pregnancy

leads to liver failure with elevated transaminaseas and abnormal INR

28

Case 35yo M pruritis, RUQ pain, ulcerative colitis, prednisone tx

AST Alt elevated
Alk phos very elevated

perinuclear antineutrophlic cytoplasmic Ab - 1:1280

primary sclerosing cholangitis

29

hemochromatosis

iron overload state with elevated transferrin

hyperpigmentation**

30

acute cholecystitis

acute symptoms with eating fatty meal and females of late repro age who are overweight

5 Fs