Hepatits

Question 1

What is hepatitis?

Answer 1

inflammation of the liver

self-limiting or leads to fibrosis and cirrhosis

Question 2

Symptoms of hepatitis virus?

Answer 2

malaise
muscle and joint pain
fever
n/v
diarrhea
HA

Question 3

Specific symptoms of liver dysfunction

Answer 3

Jaundice
abd discomfort
lymphadenopathy
splenomegaly

Question 4

Strains of Viral Hepatitis

Answer 4

A through E

Question 5

Viral hepatitis strains causing acute infection

Answer 5

A and E

Most common is A

Question 6

Viral hepatitis strains causing chronic infection

Answer 6

B and C

Question 7

Acute or chronic: 2-6 weeks, Hep A virus

Answer 7

Acute

Question 8

Acute or chronic: longer duration, associated with extensive liver damage and scarring, Hep B and C virus

Answer 8

Chronic

Question 9

Nonviral causes of chronic hepatits

Answer 9

alcohol abuse
drug intoxication
autoimmune processes

Question 10

Hepatitis associated with high levels serum immunoglobulins, auto-antibodies, marked elevation of gamma globulins

Answer 10

autoimmune hepatitis

Question 11

Hepatic failure or insufficiency that progresses from onset of hepatitis symptoms to hepatic encephalopathy within 2-3 weeks

Answer 11

acute fulminant hepatitis

Question 12

Name two major types of reactions involved in hepatic detoxification

Answer 12

phase 1 and phase 2

biotransformations

Question 13

What does phase 1 rxn involve?

Answer 13

chemical modification of reactive drug groups through oxidation,reduction,hydroxylation, or other chemical rxn
i
nvolves gene CYTOCHROME P450 to produce CYP enzyme that metabolizes drugs

Question 14

What does phase 2 rxn involve?

Answer 14

conversion of lipid-soluble derivatives to water-soluble substances-CONJUGATES
involves drug coupled with GLUTATHIONE

Question 15

Leading cause of liver failure in US

Answer 15

Drug-related hepatotoxicity

Question 16

Most common cause of drug-related liver damage

Answer 16

Acetaminophen

Question 17

Factors to liver susceptibility

Answer 17

genetic predisposition
age
overall liver function
diet
alcohol consumption
other interacting drugs

Question 18

What does the liver use to detoxify alcohol?

Answer 18

alcohol dehydrogenase (ADH)
microsomal ethanol-oxidizing system (MEOS)

Question 19

Name the toxic intermediate ADH and MEOS produces during detoxification

Answer 19

acetaldehyde

Question 20

How does drinking alcohol lead to accumulation of fats in the liver?

Answer 20

Oxidation reaction by ADH lead to conversion of NAD to NADH.
NAD is required for fattty acid oxidation therefore a decrease limits body’s ability to metabolize FA and results in accumulation in the liver

Question 21

Why are women more predisposed to alcohol induced liver damage?

Answer 21

Testosterone depresses ADH system (women have less)

Women produce more toxic acetaldehyde

Question 22

Name the three spectrums of alcoholic liver disease

Answer 22

fatty liver disease
alcoholic hepatitis
cirrhosis

Question 23

Accumulation of fat in hepatocytes

Answer 23

steatosis

a characteristic of fatty liver dz

Question 24

Is fatty liver dz reversible?

Answer 24

Yes, after the alcohol intake has been discontinued

Question 25

Characterized by inflammation and necrosis of liver cells caused by excessive alcohol intake

Answer 25

alcoholic hepatitis

Question 26

Cardinal sign of alcoholic hepatits

Answer 26

Rapid onset jaundice

Question 27

End result of long-term alcohol abuse

Answer 27

alcoholic cirrhosis

Question 28

Liver damage can lead to

Answer 28

portal hypertension collateral vessels-esophageal varacies cholestasis

Question 29

Accumulation of fat in the liver not caused by alcohol use/abuse

Answer 29

Nonalcoholic Fatty Liver Disease (NAFLD)

Question 30

Coexisting conditions frequently associated with fatty liver disease

Answer 30

Obesity type 2 diabetes metabolic syndrome hyperlipidemia

Question 31

How do ketones and fatty acids contribute to NAFLD

Answer 31

they stimulate cytochrome P450 and MEOS resulting in lipid peroxidation causing hepatocyte injury, inflammation, and fibrosis

Question 32

How do you diagnoses NAFLD

Answer 32

mild elevations of AST and ALT liver ultrasound liver biopsy

Question 33

Treatment aim for NAFLD

Answer 33

``` weight loss exercise no alcohol vitamin E replacement reducing lipids in diet ```