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Flashcards in Hepatology Deck (283)
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1
Q

quid of amebic liver disease

A

tender liver mass on abdominal ct scan

2
Q

rx of amebic abcess

A

metronidazole

3
Q

patient with hepatic mass after traveling in endemic areas

A

amebic abcess

4
Q

drug causing idiosyncratic reaction hepatitis(4)

A

halothane
phenytoin
isoniazid
@-methyl dopa

5
Q

drugs causing cholestasis(4)

A

chlorpromazine
erythropoietine
anabolic steroids
nitrofurantoin

6
Q

drugs causing fatty liver disease(3)

A

tetracycline
acid valproic
ARV

7
Q

drugs causing granulomatous reaction(2)

A

allopurinol

phenylbutazone

8
Q

2 ways for drugs to cause injury

A

toxic effect

idiosyncratic reaction

9
Q

quid of toxic effect

A

reaction is dose dependent

10
Q

example of toxic efffect(2)

A

tetracycline

acetaminophen

11
Q

quid of idiosyncratic effect

A

reaction is dose independent

12
Q

example of idiosyncratic effect(2)

A

isoniazid

ARV

13
Q

clue for non alcoholic steato hepatitis NASH(4)

A

non drinker
serologic hepatitis negative
obese with high ALP
slightly increase SGOT,SGPT

14
Q

link to have NASH

A

obesity

15
Q

why obesity causes NASH

A

fat cells are not responsive to insulin and lipid is deposited in the liver

16
Q

how ‘s ALT/AST in NASH

A

AST/ALT

17
Q

dx of NASH

A

Liver biopsy

18
Q

risk factor for NASH(5)

A
obesity
diabete
hyperlipidemia
parenteral nutrition
medications
19
Q

medication risk factor for NASH(5)

A
corticosteroids
tamoxifen
amiodarone
diltiazem
HAART
20
Q

quid of Murphy sign

A

RUQ pain worst during inspiration

21
Q

clue for acute cholecystitis

A

pain in RUQ worsen with fatty liver meal

22
Q

ALP in chlocystitis

A

normal

23
Q

where ‘s stone in acute cholecystitis

A

in the cystic duct

24
Q

RUQ pain with high ALP(2)

A

cholangitis
or
choledocolithiasis

25
Q

why you have fever in cholecystitis

A

secondary infection

26
Q

why infection can happen in acute cholecystitis(2)

A

because of inflammatio you can have stasis and bacterial overgrowth
risk of gangrene and perforation

27
Q

what’s the first step to address in case of variceal bleeding

A

2 large bore IV needles or central line

28
Q

patien with acute pancreatitis develops palpable epigastric mass

A

pseudocyst formation

29
Q

why amylase is elevated in pseudocyst

A

leak of amylase from the pseudocyst into the circulation

30
Q

best image to Dx pseudocyst

A

US

31
Q

rx of pseudocyst(2)

A

observation

resolve spontaneously

32
Q

indication of drainage of pseudocyst(3)

A

more than weeks persistance
infection
> 5 cm

33
Q

patient with high bilirubin direct and hgh ALP next step(3)

A

CT
or
US
+ antimitochondrial antibody

34
Q

panacinar emphysema plus cirrhosis

A

@-1 antitrypsine deficiency

35
Q

rx of @ antitrypsine deficiency

A

Alpha 1 anti trypsine factor

36
Q

asymptomatic elevation of transaminase next step?

A

good history on risk factor

37
Q

risk factor for hepatitis(5)

A
drug
alcohol
endemic area travel
blod transfusion
high risk sexual practices
38
Q

Med causing high transaminase(5)

A
NSAIDS
HMGco A reductase inhibitor
antiepileptic drugs
izoniazid
herbal preparation
39
Q

clue for acute pancreatitis(3)

A

epigastric pain
rlieve by leaning forward
occuring after binge eating

40
Q

rx of acute pancreatitis(4)

A

conservatively
analgesics
fluid
NPO

41
Q

analgesics used in acute pancreatitis(2)

A

fentanyl

meperidine

42
Q

most common type of gallstone in US

A

cholesterol stone

43
Q

2 types of gallstone(2)

A

cholesterol

calcium bilirubinate

44
Q

dx of choice of cholecystitis

A

US abdomen

45
Q

rx for symptomatic cholecystitis

A

laparoscopic cholecystectomy

46
Q

patient with microcytic anemia and firm hepatomegaly

A

metastatic cancer from colon

47
Q

first site for matastasis pf colon cancer

A

hepatic

48
Q

goal standard for metastatic hepatic colon cancer

A

abdomen CT scan

49
Q

tinding in CT during metastatic hepatic colon cancer

A

cholestatic syndrome

50
Q

PBC clue

A

antimitochondrial antibody type IGM

51
Q

Biopsy of PBC(2)

A

destruction of intrahepatic bile ducts and cholestasis

medium size bile duct

52
Q

first symptom of PBC and why?(2)

A

pruritis

because of cholestasis

53
Q

conditions associated with PBC(5)

A
sjogren
scleroderma
celiac disease
autoimmiune thyroid problem
hypothyroidism
54
Q

drug of choice fro PBC treatment

A

ursodeoxycholic acid

55
Q

definitive rx of PBC and severe disease

A

liver transplant

56
Q

jews with ictere

A

dubin jhonson

57
Q

work up for dubin jhonson(2)

A

Normal AST/ALT

high bilirubin conjuguee

58
Q

differentiate dubin jhonson from rotor

A

dark granular pigment seen in hepatocytes=Dubin jhonson

59
Q

mechanism of gynecomastia in cirrhosis

A

excess of estrogen in the body

60
Q

mechanism in testicular atrophy in cirrhosis

A

lot

61
Q

why T3T4 are low in cirrhosis

A

no protein to bind T3T4

62
Q

why TSH is normal in cirrhosis

A

because you lack thyroid binding globulin not T3T4

63
Q

2 causes in cirrhosis causing hypogonadism(2)

A

hemochromatosis

alcohol

64
Q

what causes hypogonadism(2)

A

primary hypogonadism

secondary due to hypothalamo hypophysaire dysfuction

65
Q

why lung can have problem in cirrhosis

A

hapatic hydrothorax

66
Q

why edema in cirrhosis

A

low albumin level

67
Q

why hepatic hydrothorax in cirrhosis

A

defect of diaphragm allows ascites fluid to go in pleural space

68
Q

patient with cirrhosis on diuretics develops pleural fluid effusion ,next step

A

TIPS

transjugular porto systemic shunt

69
Q

cirrhosis and shortness of breath

A

pleural effusion

70
Q

forst rx for hepatic hydrothorax(2)

A

diuretic

fluid restriction

71
Q

Triad of charcot(3)

A

ictere
fever
RUQ pain

72
Q

pentad of renold(3)

A

triad de charcot
plus
hypotension
confusion

73
Q

pentad of renold or charcot disease?

A

cholangitis

74
Q

clue for acute cholangitis

A

high ALP

75
Q

first step in rx of cholangitis

A

antibiotics

76
Q

patient with cholangitis ,getting worse with antibiotics next step

A

surgical decompression

77
Q

what’ts the best indicator of progression of HEP C infection in liver

A

biopsy

78
Q

role of biopsy in HEP C infection(4)

A

stage of the disease
rule out concommitant disease
guide rx decision
surveillance

79
Q

electrolyte abnormality in cirrhosis

A

low K+

80
Q

step of management of hepatic encephalopathy(4)

A

supportive care
rx the precipitating cause
correct volume and electrolyte problem
lower ammonia

81
Q

way to lower ammonia

A

lactulose

82
Q

when you can add rifamixin in the rx of high ammonia in cirrhosis

A

when failure with lactulose after 48 h de rx

83
Q

Burn Patient develops RUQ pain

A

acalculous cholecystitis

84
Q

lactulose side effect

A

rifamixin

85
Q

quid of acalculous cholecystitis

A

inflammation of gallbladder without calcul

86
Q

conditions predisposing to acalculous cholecystitis(5)

A
severe   burns
severe trauma
prolonged TPN
prolonged fasting
mechanical ventilation
87
Q

complication of acalculous cholecystitis(3)

A

gangrene
perforation
emphysematous changes

88
Q

initial work up for acalculous cholecystitis(3)

A

US abdomen
more specific
HIDA scan
CT scan

89
Q

IV drugs user with ascites

A

chronic liver disease

90
Q

most common cause of chronic liver disease

A

alcohol

hep c

91
Q

why splenomegaly in cirrhosis

A

because of portal HTA

92
Q

rx of hepatitis B preferred drug(2)

A

tenofovir

entecavir

93
Q

drug used in rx of hep B(4)

A

tenofovir
entecavir
interferon
3TC

94
Q

Indication of rx(6)

A

acute liver disease
clinical complications of cirrhosis
advanced cirrhosis with with high HBV DNA
Patient without cirrhosis but with positive HBe AG,
HBV DNA>20000

95
Q

why TDF and entecavir are prefered (2)

A

low risk of resistance

can be used in decompensated cirrhosis

96
Q

cirrhosis and encephalopathy Rx

A

lactulose

97
Q

cause of precipitation of cirrhosis(9)

A
infection 
hypoxia
hypoglycemia
hypovolemia
porto systemic shunt
excessive nitrogen load
medication
hypokaliemia
metabolic alkalosis
98
Q

medication percipitating cirrhosis

A

sedatives

99
Q

cause of excessive nitrogen load

A

bleeding

100
Q

4 phases in chronic infection caused by hepatitis B

A

immune tolerance
imune clearance
inactive carrier state
reactivatio

101
Q

clue for immune tolerance(4)

A

high antigene HBS
High HBE antigene
high HBV replication
minimal destruction of hepatocytes

102
Q

duree of immune phase

A

10 a 30 years

103
Q

what happened in imune clearance phase

A

destruction of hepatocytes containing HBV

104
Q

clue for this phase(2)

A

ALT high or normal

HBE antigene positive

105
Q

meaning of HBe

A

active replication is occuring

106
Q

what to do in the phase of ICP

A
serial ALT(q3-q 6 months)
serial HBe Ag
107
Q

why serial ALT and HBe in ICP

A

to fully document clearance

108
Q

clue for inactive carrier(3)

A

Hbe ag -
Hbe aB +
Low HBV DNA

109
Q

indication to conclude inactive carrier state(2)

A

> / a 3 Normal ALT

2 a 3 Normal HBV DNA

110
Q

cue for reactivation of HepB(3)

A

high ALT
high HBV
fibrosis on biopsy

111
Q

how to follow patient with chronic Hep B

A

serial ALT

112
Q

what should be done to any patient with chronic hepatis

A

vaccination for Hep A and B

113
Q

what should be done to any patient with hepatitis C infection

A

vaccination for Hep A and B

114
Q

indication of rx in chronic Hep C(4)

A

age > 18 ans
detectable serum RNA
compensated liver disease
liver biopsy with fibrosis

115
Q

quid of compenated corrhosis(2)

A

INR normal

116
Q

rx of chronic Hepatitis C(2)

A

Peginterferon
plus
ribarivirin

117
Q

indication of protese inhibitor in rx of hepatitis C infection

A

HCV 1

118
Q

contrindication of rx with protease inhibitor(3)

A

uncontrolled depression
alcohol
drug abuse

119
Q

protease inhibitor used in HCV infection(2)

A

telaprevir

boceprevir

120
Q

patient with cirrhosis high ALT and AST and brownish deposit around cornea

A

wilson disease

121
Q

quid of keyser fleisher ring

A

brownish deposit around cornea

122
Q

biopsy finding in wilson

A

hepato lenticular degeneration

123
Q

why psychiatric problem in wilson

A

copper leak fromhepatocytes and deposit in basa ganglia

124
Q

eye problem in wilson

A

keyser fleisher ring

125
Q

dx test for wilson(3)

A

liver biopsy
low ceruloplasmin
low copper in urine

126
Q

finding in liver biopsy

A

copper >250 Mcg

127
Q

meaning of low ceruloplasmine

A
128
Q

confirmatory dx test

A

keyser flesher ring

129
Q

Rx of wilson(2)

A

Penicillamine or trientine
plus
ZN

130
Q

when liver transplantation is indicated in wilson(2)

A

decompensated liver disease

fulminant hepatic failure

131
Q

best rx of choledocholithiasis

A

laparoscopic cholecystectomy

132
Q

in case of a patient refusing the surgical rx of choledocholithiasis(2)

A

ursodesoxycholic acid

avoid fatty foods

133
Q

pancreatitis in non alcoholic patient

A

gallstone

134
Q

Rx of pancreatitis in non alcoholic patient

A

cholecystectomy

135
Q

mid epigastric pain with high lipase and amylase

A

acute pancreatitis

136
Q

quid of hapatic adenoma

A

hepatic tumor in young female taking OCP

137
Q

complication of hepatic adenoma(2)

A

intratumor hemorrage

malignant tranformation

138
Q

biopsy in hepatic adenoma

A

enlarged heaptocytes containing glycogen and lipid deposits

139
Q

rx of hepatic encephalopathy

A

serum ammonia level

140
Q

why hyperandrogenism in aptient with cirrhosis

A

inabiloity of the liver to metabolise estrogen

141
Q

effect of high estrogen in cirrhosis(5)

A
spider angioma
gynecomastia
little testicle
palmar erythema
decreased body haior
142
Q

liver function(3)

A

metabolic
synthetic
excretoire

143
Q

liver synthesis(3)

A

protein
cholesterol
clot factor

144
Q

excretory role of liver

A

bile

145
Q

metabolic role of liver(2)

A

detoxification of drug

and steroids

146
Q

clue for amebic liver disease(4)

A

trip to mexico
history of bloody diarrhea
RUQ pain
uniform cyst in right lobe

147
Q

risk factor for gallbladder carcinoma(3)

A

chronic gallblader inflammation
porcelain gallbaldder
salmonella typhi carriage

148
Q

chronic gallblader inflammation cause

A

stones

149
Q

indication of cholecystectomy in gallbladder carcinoma

A

when ca is confined to gallbladder wall(lamina propria)

150
Q

risk factor for porcelain gallblader

A

chronic inflammation by gallstones

151
Q

complication of porcelain gallbladder

A

cancer

152
Q

glomerulonephritis with low complement(4)

A

GNA
MPGN
Lupus
Mixed cryoglobulinemia

153
Q

link between Cryoglobulinemia and RA(2)

A

IGM will be targeted towards IGG

rhumatoid factor can be positive

154
Q

quid or cryo

A

it’s a vasculitis

155
Q

target in cryo (4)

A

articulation
skin
rein
foie

156
Q

skin finding in mixed Cryo

A

purpura

157
Q

first step in aptient with suspected mixed cryo

A

test for hepatitis C

158
Q

confirmatory Dx for mixed Cryo(2)

A

kidney biopsy
or
skin biopsy

159
Q

clue for porphyria cutanea tarda(3)

A

photosensitivity
fragile skin
erosion and vesicles on dorsum of the hands

160
Q

disease causing porphyria cutanea tarda

A

mixed cryo

161
Q

clue for Mixed Cryo

A

periodic increase of Tranaminases

162
Q

complication of Mixed cryo(2)

A

cirrhosis

hepatocellular carcinoma

163
Q

cause of Non alcoholic fatty liver disease in obese patient

A

insulin resistance

164
Q

physiopatho af NAF liver disease(3)

A

high lipllysis in periphery
high triglyceride synthesis
high hepatic uptake of fatty acids

165
Q

criteria for NAF liver disease(3)

A

steatohepattitis

viral serology -

166
Q

patient with virl hepatitis develops high PT and decresed transaminases Dx

A

Fulminant hepatitis

167
Q

decrease transaminase in the setting of viral hepatitis meaning?(2)

A

recovery

fulminant hepatitis

168
Q

patient with positive HBS antibody (2)

A

vaccination

prior infection

169
Q

first marker to be positive in Hep B

A

Hbs Ag

170
Q

second marker to be positive in Hep B

A

anti hbc IGM

171
Q

most specific marker to Dx acute Hep B

A

IGM HBC antibody

172
Q

why Hbc ag can not be seen

A

it’s sequestered within HBS ag coat

173
Q

Meaning of HBe Ag

A

infectivity

174
Q

Meaning of HBe Antibody

A

low infectivity

175
Q

Meaning of HBc antibody

A

recovery

176
Q

what are the 3 types of gallstones

A

cholesterol
pigment stone
mixed stone

177
Q

quid of pigmented stones

A

calcium bilirubinate stones

178
Q

why pregnant women are prone for cholesterol stones

A

hypomotility of gallbaldder

179
Q

cause of gallbaldder hypomotility(4)

A

advanced age
TPN
prolonged fasting
hypertriglyceridemia

180
Q

5 causes of cholesterol gallstones formation

A

hypomotile gallbladder
malabsorption of acid biliaire
OCP
Meds

181
Q

Med causing cholesterol stones(3)

A

clofibrate
octreoctide
ceftriaxone

182
Q

risk factor for pigmented stones(3)

A

hemolysis
chronic biliairy tract infection
parasitic infection

183
Q

protective factor against stones(5)

A
NSAIDS
Aspirin
caffeine
physical activity
low carbohydrate diet
184
Q

quid pof Hepatic shock

A

patient with low TA develops high AST/ALT with mild elevation of bilirubin

185
Q

what happen in hepatic shock

A

ischemic hepatic injury

186
Q

pregnant women develop Hep C infection next step(2)

A

Hep A vaccine

Hep B vaccine if not immune

187
Q

clue for hepatic cyst (hydatic)(2)

A

thick wall cyst

egg shell calcification

188
Q

cause of hepatic cyst

A

ecchinococus granulosis

189
Q

what you should not do in hydatid cyst

A

aspiration of the cyst

190
Q

why you should not aspirate in hydatid cyst

A

risk of hypersensitivity

191
Q

rx in hydatid cyst

A

surgery under albendazole coverage

192
Q

quid of fulminant hepatic failure

A

acute viral hepatitis complicated with encephalopathy

193
Q

rx of FHF

A

orthotopic liver transplant

194
Q

other way of considering FHF

A

hepatic encephalopathy within 8 weeks of acute liver disease

195
Q

young person with high transaminase and neurologic finding resting tremor and muscular rigidity

A

wilson

196
Q

FHF in pregnant women in 3 e trimestre

A

Hep E

197
Q

all patients receiving blood before 1986

A

screen Hep B and C

198
Q

all patients receiving blood before 1992

A

screen Hep C

199
Q

after marrow transplantation pateint develops decreased bile ducts quantity in liver biopsy what disease has the same pattern

A

PBC

200
Q

cause of ductopenia(8)

A
PBC
hogkin
sarcoidosis
cmv infection
HIV
Med induced
failing liver transplantation
graft versus host disease
201
Q

after marrow transplantation pateint develops decreased bile ducts quantity in liver biopsy dx

A

graft versus host disaese

202
Q

most common cause of ductopenia

A

PBC

203
Q

other name for ductopenia

A

vanishing bile duct syndrome

204
Q

asian american with ictere bilirubin in urine

A

rotor

205
Q

quid of bilirubin in urine

A

conjugated hyperbilurubinemia

206
Q

bilirubin in gilbert

A

high conjugated hyper bilirubinemia

207
Q

patient taking INH develops high transaminase

A

continue with RX

will resolve spntaneously

208
Q

patient with multiple trou noir on CT scan

A

metastatic disease from colon cancer

209
Q

primary cancer to metastase in liver(3)

A

colon cancer
lung
breast

210
Q

clue for Ca in the United states

A

weight loss

211
Q

test of choice for pancreatic cancer

A

CT abdomen

212
Q

3 causes of decompensated liver with high transaminase

ALT>AST(3)

A

medication
viral hepatitis
shock liver

213
Q

medication causing decompensated liver with high transaminase

A

acetaminophen

214
Q

antidote of paracetamol intox

A

acetylcysteine

215
Q

Transminase in severe hepatic injury

A

> 1000

216
Q

3 causes of ALT>AST(3

A

medication
viral hepatitis
shock liver

217
Q

complication of elective cholecystectomy

A

sphincter d’oddy dysfunction

218
Q

3 causes of ALT>AST(3

A

medication
viral hepatitis
shock liver

219
Q

complication of elective cholecystectomy

A

sphincter d’oddy dysfunction

220
Q

rx of sphincter d’oddy dysfunction

A

ERCP with sphicterotomy

221
Q

patient after elective cholecystectomy has persistent RUQ pain DX?

A

sphincter d’oddy dysfunction

222
Q

ratio AsT/ALT in alcoholic patient(2)

A

AST/ALT >2

or
AST >ALT 2f

223
Q

why in alcoholic patient AST >ALT

A

deficiency in pyridoxal 6 phosphate

224
Q

quid of in pyridoxal 6 phosphate

A

cofactor of ALT

225
Q

U/s in emphysematous cholecystitis (2)

A

circular linear shadows gaseaous in gallbladder

no gall stones

226
Q

patient with RUQ pain ,abdominal xray showing air fluid level in the gallbladder

A

emphysematous cholecystitis

227
Q

U/s in emphysematous cholecystitis

A

circular linear shadows gaseaous in gallbladder

228
Q

cholecystitis with no gall stones

A

acalculous

emphysematous

229
Q

cause of emphysematous cholecystitis

A

gas forming bacteria

230
Q

clue for Hep A infection (2)

A

trip in Mexico
or
endemic area

231
Q

risk factor for Emphysematous cholecystitis

A

diabetes

232
Q

clue for Hep A infection

A

trip in Mexico

233
Q

the most common malignant in liver

A

metastasis

234
Q

patient alternance of dairrhea and constipation presenting with high ALP and multiple hepatic nodules on CT Dx?

A

Metastasis from colon cancer

235
Q

Multiple nodules in Liver Next step

A

check GI for primary Cancer

236
Q

transaminase in hepatic shock

A

ALT

AST > 1000

237
Q

transaminase in post op cholestasis(2)

A

Normal AST ALT

High ALP

238
Q

hepatic shock

A

ALT

AST > 1000

239
Q

quid of asymptomatic gallstones

A

gallstones seen in US but no Symptom

240
Q

rx for asymptomatic gallstone

A

nothing

241
Q

rx for symptomatic gallstone

A

laparoscopic cholecystectomy

242
Q

normal liver span

A

6-12 cm in the midclavicular line

243
Q

3 types of hepatic liver disease linked with alcohol(3)

A

fatty liver
alcoholic hepatitis
alcoholic fibrosis /cirrhosis

244
Q

clue for fatty liver in biopsy

A

steatosis

245
Q

clue for alcoholic hepatitis in biopsy(4)

A

mallory body
liver cell necrosis
perivenular distribution of inflammation
liver cell necrosis

246
Q

what the 2 phases reversible with cessation alcohol

A

steatosis

hepatitis

247
Q

clue for hypertriglyceridemia in a patient with suspected acute pancreatitis

A

xanthomas

248
Q

quid of XAnthoma

A

yellow red papules on arms and shoulders

249
Q

mechanism of xanthoma(2)

A

fat deposit on tendon

or in subcutaneous tissue

250
Q

in acute pancreatitis what to always do

A

order profile lipidic

251
Q

bleeding in liver failure(2)

A

varices

coagulopathy

252
Q

manif of varices

A

hematemesis

253
Q

manif of caogulopathy

A

epistaxis

bleeding from IV sites

254
Q

management of coagulopathy

A

fresh frozen plasma

255
Q

what cause coagulopathy in liver failure

A

all clot fator are formed in the liver except factor 8

256
Q

why FFP is the best treatment in coagulopathy caused by liver failure

A

because it has all the clotting factor

257
Q

screening test for acute Hep B(2)

A

IGm HBc antibody

HBs Ag

258
Q

drug of choice for PBC

A

ursodeoxycholic acid

259
Q

Dx differentiel in patient with indirect high bilirubinemia(4)

A

hemolysis
gilbert
criggler najar

260
Q

=/ gilbert from criggler Najar type 1(2)

A

high bilirubin in Criggler Najar 20-25

in gilbert 3 a 5

261
Q

quid of SAAG

A

serum albumin ascire gradient

262
Q

SAAG calculation

A

albumin serique-albumin ascites

263
Q

SAAG> 1,1

A

hypertension portale

264
Q

AES in patient with acute phase of hepatite B,patient pique non immune a hep B(2)

A

vaccine +

immunoglobulin

265
Q

quid for acute phase of Hep B(4)

A

IgM anti HBc
Hbs Ag
HBe Ag
DNA +

266
Q

quid of window phase

A

IgM anti Hbc +

DNA positive

267
Q

quid of recovery phase(4)

A

anti HBe
antihbc iGG
anti HB s
DNA -

268
Q

chronic carrier(2)

A

HBS ag

IGG anti HBC

269
Q

acute flare of chronic

A

Hbs ag +
HBe Ag
IGG anti HBc
DNA +

270
Q

vaccinated patient

A

anti hbs ag

271
Q

immune by contact with the virus

A

IgG anti HbC

anti HBS ag

272
Q

PAS positive in hepatology

A

@-1 anti trypsine deficiency

273
Q

Symptom of hypogonadism(3)

A

decraese libido
eerctile dysfunvtion
loss of axillary and pubic hair

274
Q

indication of TIPS

A

refractory hydrothorax in cirrhosis

275
Q

step in hepatic encephalopathy

A

search for precipitating cause

276
Q

approach to chronic hepatitis C

A

Serial ALT to follow up

277
Q

what’s the next step after rx acute pancreatitis caused by gallstones

A

schedule cholecystectomy

278
Q

clue helping in the Dx of cirrhosis encephalopathy

A

serum ammonia

279
Q

when to make dx of gallbladder carcinoma(2)

A

per-op
or
post op

280
Q

immunlogy in mixed cryo

A

IGM is directed towards IGG anti hepatite C virus

281
Q

when to suspect Hep C infection

A

waxing and waning increase of transaminases

282
Q

extrahepatic manif of chronic hep C(3)

A

mixed cryo
porphyria cutanea tarda
membranoproliferative glomerulonephritis

283
Q

hepatitis induced by INH transaminase less than 100

A

continue with the rx