Hepatology Flashcards

(35 cards)

1
Q

Metabolism and detoxification of drugs are dependant on what system?

A

An effective liver enzyme system

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2
Q

What is jaundice?

A

Yellowish pigmentation of the skin, conjunctiva, and other mucous membranes

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3
Q

What is hyperbilirubinemia?

A

A build up of bilirubin in the blood, this causes the yellow colour in jaundice

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4
Q

What is the first thing to change colour when bilirubin levels rise?

A

Conjunctiva

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5
Q

What is the conjunctiva?

A

The conjunctiva is a tissue that lines the inside of the eyelids and covers the sclera (the white of the eye)

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6
Q

What is pre hepatic jaundice?

A

Excessive red cell breakdown which overwhelms the liver’s ability to conjugate bilirubin. This causes an unconjugated hyperbilirubinaemia.

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7
Q

What is hepatic jaundice?

A

Dysfunction of the hepatic cells. The liver loses the ability to conjugate bilirubin

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8
Q

What is post hepatic jaundice?

A

Obstruction of biliary drainage

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9
Q

Potential causes for pre hepatic jaundice? (4)

A
  • Malaria
  • Sickle cell anaemia
  • Thalassemia
  • Gilbert’s syndrome
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10
Q

Potential causes for hepatic jaundice? (6)

A
  • Viral Hepatitis
  • Drug induced hepatitis
  • Alcoholic liver disease
  • Hepatotoxicity
  • Cirrhosis
  • Leptospirosis
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11
Q

Potential causes for post hepatic jaundice? (4)

A
  • Gallstone
  • Pancreatic cancer
  • Liver flukes
  • Stricture of bile duct
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12
Q

What does the outer envelope of the HBV contain? (3)

A
  • Hepatitis B surface antigen protein (HBsAg)
  • Glycoproteins
  • Cellular lipid
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13
Q

Where is the highest prevalence of the HBV infection?

A

Sub-saharan Africa and East Asia

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14
Q

What are the modes of transmission for HBV? (5)

A
  • Perinatal
  • Sexual
  • Blood transfusion
  • Intravenous drug user
  • Needle-stick injury
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15
Q

What does the Hepatitis B vaccination contain?

A

HBsAg adsorbed onto aluminium hydroxide adjuvant

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16
Q

What percentage of adults are non responders to the Hep B vaccine?

17
Q

What would be the antibody titre for a;

  • Non responder
  • Poor responder
  • Good responder
A
  • <10
  • 10-100
  • > 100
18
Q

If a person has an antibody titre of <10 (besides being a non responder) would could this suggest? (3)

A
  • Natural immunity due to past infection
  • Incubating actue Hep B
  • Carrier of Hep B
19
Q

Interpret the following

HBsAg (-)
Anti-HBc (-)
Anti-HBs (-)

A

Susceptible to Hep B

20
Q

Interpret the following

HBsAg (-)
Anti-HBc (+)
Anti-HBs (+)

A

Immune due to natural infection

21
Q

Interpret the following

HBsAg (-)
Anti-HBc (-)
Anti-HBs (+)

A

Immune due to Hep B vaccination

22
Q

Name 2 treatments for HBV

A
  • Lamivudine

- Interferon

23
Q

What is Hepatitis D?

A

Virus that requires HBV for its replication. HDV infection occurs only simultaneously or as super-infection with HBV.

24
Q

What are the routes of transmission for HCV? (4)

A
  • Blood transfusion
  • Intravenous injection
  • Nosocomial transmission (Hospital transmission from needle stick, colonoscopy)
  • Rarely sexually transmitted
25
What is the treatment available for HCV? (2)
- Pegylated interferon - Ribavirin (Used together)
26
What type of vaccination is available for HCV?
No vaccination available
27
What is the structure of the Hepatitis A virus? ``` Enveloped? Shape? Single/Double stranded? Sense? Type of RNA? ```
- Non-enveloped - Spherical - Single stranded - Positive sense - Linear RNA
28
What is the structure of the Hepatitis C virus? Enveloped? Shape? Single/Double stranded? Sense?
- Enveloped - Spherical - Single stranded - Positive sense
29
What are the risk factors of HAV? (5)
- Children/Staff in childcare facilities - Patients/Staff in mental health institutions - Homosexual males - Intravenous drug user - Travellers in endemic areas
30
What are some of the symptoms of Acute Hepatitis A?
- Fever - Headache - Malaise - Anorexia - Vomiting - Weight loss
31
What is Cholestasis? What is it a clinical feature of?
- Dark urine and pale stools | - HAV
32
When investigating HAV what do the presence of the following antibodies indicate? - HAV IgM - HAV IgG
- HAV IgM indicates acute phase of infection | - HAV IgG indicates past infection
33
What is the structure of the Hepatitis E virus? Enveloped? Shape? Single/Double stranded? Sense?
- Non-enveloped - Spherical - Single stranded - Positive sense
34
What are the routes of transmission for HEV? (4)
- Waterborne - Foodborne - Blood transfusion - Zoonotic transmission (animals)
35
When investigating HEV what do the presence of the following antibodies indicate? - HEV IgM - HEV IgG
- HEV IgM indicates acute phase of infection | - HEV IgG indicates past infection