L4: Chronic Viral Hepatitis & Cirrhosis Flashcards
(67 cards)
1
Q
Characters of The Liver
A
2
Q
Functions of The Liver
A
3
Q
Def of chronic hepatitis
A
- Inflammation of the liver.
- Persistence more than 6 months → chronic
4
Q
Cause of Chronic Hepatitis
A
5
Q
Etiology of Viral Hepatitis
A
6
Q
Compare between Hepatitic viruses in terms of:
- Trnasmission
- Classification
- Antigens
- Incubation Period
- Severity/Chronicity
- Vaccine
A
7
Q
MOT of HBV
A
HBV is transmitted hematogenously and sexually.
8
Q
HBV Patients can have either an acute symptomatic disease or an asymptomatic disease.
A
..
9
Q
antigen-antibody system in HBV
A
10
Q
HBs Ag
A
- The marker of infectivity.
- It can be found in blood and body secretions: salive, urine, semen, vaginal secretion, tears, sweat.and breast milk.
11
Q
Anti-HBs
A
- Protective antibody.
- can persist for many years
- Appears after HBAg disappearance several weeks (or months).
12
Q
HBc Ag
A
A marker of replication.
13
Q
Anti-HBc IgM
A
A marker of acute infection and acute attack of chronic infection.
14
Q
Anti-HBc IgG
A
A marker of past infection.
15
Q
Hbe Ag
A
A marker of active replication.
16
Q
Anti-Hbe
A
A marker of reduced infectivity.
17
Q
HBV-DNA
A
- The direct indicator of HBV infection
- It can integrate into the genome of hepatocytes.
18
Q
Dx of HBV
A
- Clinical picture.
- Laboratory investigations.
- Radiological investigations.
- Pathological investigations.
19
Q
CP of HBV
A
- Persistent / intermittent fatigue
- Upper right quadrant pain
- Jaundice
- Weakness
- Anorexia
- Muscle & joint pain
- Often asymptomatic
20
Q
If progressive liver disease, the following symptoms may appear
A
21
Q
Signs of chronic liver disease include the following:
A
22
Q
Lab tests for HBV
A
23
Q
Radiological tests for HBV
A
24
Q
Complications of HBV
A
25
Prevention of HBV
26
MOT of HBV
Parenteral through blood and body secretions as saliva, urine, semen, vaginal secretion, tears, sweat. And breast milk.
27
TTT of HBV
28
what is the most common cause of liver transplantation?
HCV
29
Characters of HCV
- Flaviviral etiology discovered in 1989
- Formerly "non-A non-B hepatitis": NANBH
- Unlike HBV, persistence and chronic progressive disease is usual outcome in adult infection
30
Antigen-antibody system in HCV
- The concentration of HCV in blood is low.
- Anti-HCV is the indicator of infection and the marker of infectivity
- HCV-RNA may be detected from blood or liver tissue, It's the direct evidence of infectivity
31
Signs & Symptoms of HCV
32
Physical findings in HCV
33
Other common extrahepatic manifestations in HCV
34
General baseline studies in patients with suspected hepatitis C include the following
- Complete blood cell count with differential
- Liver function tests, including alanine aminotransferase level
35
MOT of HCV
36
HCV Cannot be transmitted by:
37
Complications of HCV
38
TTT of HCV
39
Direct-acting antiviral agents
40
Def of **Cirrhosis**
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Pathological Classification of **Cirrhosis**
42
Examples of causes of **Micronodular Cirrhosis**
alcohol and hemochromatosis.
43
Examples of causes of **Macronodular Cirrhosis**
chronic hepatitis B,C and alpha-1 antitrypsin deficiency.
44
Etiological types of **Cirrhosis**
- Mixed
- Post-Hepatitis
- Congestive
- Metabolic
- Biliary
- Alcoholic
- Drugs, Toxins & Chemicals (Methotrexate & Amioradone)
- Immunologic (Autoimmune)
45
what is the commonest type of cirrhosis in Egypt?
Mixed Cirrhosis
46
Mixed **Cirrhosis**
- It is a combination of hepatic schistosomiasis with chronic viral hepatitis, drug induced or malnutrition.
- pure hepatic schistosomiasis produces periportal fibrosis without parenchymal affection.
47
Post-Hepatitis **Cirrhosis**
- It complicates chronic viral e.g. chronic hepatitis B and C. also it can complicate non-viral hepatitis.
48
Congestive **Cirrhosis**
- It complicates chronic hepatic congestion as in right-sided heart failure, constrictive pericarditis and Budd-Chiari syndrome.
49
Metabolic **Cirrhosis**
- It occurs in generalized diseases with inborn errors of metabolism as in hemochromatosis and Wilson's disease.
50
Biliary **Cirrhosis**
- It is either primary or secondary to prolonged extrahepatic obstruction.
51
Alcoholic **Cirrhosis**
- It develops after many years of alcohol consumption.
- The commonest type of cirrhosis in the western countries but is rare in Egypt
52
what causes Complications of liver cirrhosis?
Complications of liver cirrhosis are due to two major events, portal hypertension and parenchymal dysfunction.
53
Portal hypertension is due to .....
obstruction of the portal blood flow within the cirrhotic liver.
54
Parenchymal dysfunction is due to ......
progressive necrosis or degeneration of the hepatic cells.
55
Complications due to portal hypertension
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Complications due to parenchymal dysfunction
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CP of Liver **Cirrhosis**
58
Investigations for **Cirrhosis**
- Lab
- Rad
- Cyto
59
Lab tests for **Cirrhosis**
60
Radiological Tests for **Cirrhosis**
* Abdominal ultrasonography
* Computed tomography (CT)
* Magnetic resonance imaging (MRI)
* Radionucleotide studies
61
Pathological test for **Cirrhosis**
Liver biopsy: the gold standard for the diagnosis of cirrhosis
62
what is the gold standard for the diagnosis of cirrhosis?
Liver Bx
63
TTT of **Cirrhosis**
64
Specific TTT in **Cirrhosis**
- Phlebotomy for hemochromatosis
- d-Penicillamine for Wilson's disease
- alcohol avoidance for alcohol-induced cirrhosis
- antiviral agents such as interferon alpha for chronic viral hepatitis C
65
Symptomatic TTT of **Cirrhosis**
- diuretic therapy and salt restriction for ascites
- lactulose, neomycin and protein restriction for encephalopathy
66
Liver Transplantation in **Cirrhosis**
it is indicated in end-stage cirrhosis
67
Screening for hepatocellular carcinoma
indicated in all cases of liver cirrhosis with serial ultrasonographic examination and serum alpha fetoprotein every six months.
