Hepatitis Pathophys Flashcards Preview

Gastrointestinal > Hepatitis Pathophys > Flashcards

Flashcards in Hepatitis Pathophys Deck (44):
1

What is the sequence of events in viral hepatitis?

1) Acute Hepatitis
2) Acute Liver Failure
3) Chronic Hepatitis

2

Once you get chronic hepatitis what happens

you get cirrhosis, liver failure, and/or hepatocellular carcinoma

3

Hepatitis A and E mostly cause what

Acute hepatitis

4

HBV mostly causes what

Acute hepatitis like A and E. The difference is that there is a greater chance that B can lead to fulminant liver failure.

A small percentage of HBV causes chronic hepatitis. This is mostly in the presence of Hep D

5

HCV causes what

chronic hep

6

hepatits pts will, of course, have an acute rise in liver enzymes (AST and ALT)

ok

7

Constitutional symptoms of acute hepatitis?

fever, fatigue, abdominal pain

8

High AST/ALT is what levels?

1,000 - 5,000....usually doesnt exceed 5,000

9

Most serious complication of acute viral hepatitis

Fulminant liver failure

10

Presentation of fulminant liver failure

altered mental status in pt with acute hepatitis.
The altered mental status is due to the hepatic encephalopathy

Fulminant liver failure mortality rate is close to 90%

11

Key test for Hepatitis A diagnosis?

IgM anti-HAV antibody

12

Key test for HEV

IgM anti-HEV antibody

13

Chronic HBV represents a vital public health problem for which part of the american population

Asian Americans...HBV is endemic to many parts of Asia

14

Positive HBsAg means what?

Active infection

15

Positive HBsAg antibody means what?

resolved infection or prior vaccination

16

Positive HBc antibody means what?

Definitely have been infected in the past...this does not show up with a vaccination

17

Positive HBe antigen means what?

Active replication and highly infectious

18

In patients with chronic HBV, what serological (plasma or serum) markers are detectable for life?

HBsAG and IgG for HBc

19

When is it appropriate to start treating chronic HBV?

When there is evidence of liver injury....meaning high ALT

20

What are the treatment goals of chronic HBV tx?

Decrease replication and minimize liver injury.
Reduce the risk of Hepatocellular carcinoma

Unfortunately, chronic HBV can only be cured in approximately 5-10% of pts.

21

All HIV fts should be tested for HBV. There chance of natural clearance is lower

ok....the good news is that some anti-HIV drugs, like Tenofovir, are also anti-HBV.

22

HBD is transmitted parenterally or enterically>

Parenterally...Needs the HBsAG to infect

23

Super-infection

When a person with CHRONIC HBV becomes infected with HDV

24

Co-infection

Just acute HBV and HDV infection occuring simultaneously

25

New CDC recommendation for HCV screening?

Anyone born between 1945 and 1965

26

Regarding HCV serotypes, the most prevalent in the US is

HCV 1

27

HCV 2 where

Developed countries (US included)

28

HCV 3

IV drug users

29

HCV 4

Middle East and North Africa

30

HCV 5

South Africa

31

HCV 6

Asia

32

Goal of HCV tx

Eradicate teh HCV...it is curable with treatment

33

Hepatocellular carcinoma is actually the most common cancer worldwide.

ok

34

What are the major risk factors for Hepatocellular carcinoma?

Chronic Hepatitis (either B or C)

35

Hepatitis C viruse causes cancer only in the setting of

Cirrhosis

36

Which of the hep viruses can cause HCC without even entering into a stage of cirrhossis?

HBV

37

Proteinuria of unknown cause calls for

Screen for HCV

38

CMV hepatitis in mmunocompromised pts. Become suspicious when you see what symptoms

Fever, diarrhea, increase in liver enzymes

39

Gold standard test for CMV?

Tissue Biopsy

40

Gold standard treatment for CMV hep

Ganciclovir

41

Hepatitis E causes what type of infection and is more severe in who?

AcutE, More severe in pregnant women and the elderly...KNOW

42

Hep A and B vaccines should be given to who

anyone with any type of liver disease

43

Which genotype of HCV has the lowest cure rate?

1

44

All HBV pts should be screeened for HCC, whereas HCV pts should only be screened if...

They have Cirrhosis