Liver Flashcards
(28 cards)
what needs to be ruled out in anyone presenting with fever and returning from endemic area within past year
malaria
- RUQ pain + tenderness
- fever
- abnormal lfts
- low albumin
- raised crp
liver abscess
investigation for liver abscess
abdominal ultrasound
Hep a virus IgM
current or recent hep A infection
Hep a virus IgG
immunity to Hep A
Hepatitis C antibdoy
indicates exposure to Hep C
how to indicate current Hep C infection
blood for Hepatitis C RNA (PCR)
what is an Amaeboic liver abscess + which country does it occur in
+ how to test for it
- type of liver abscess caused by parasitic infection
- India
- serology for antibodies for Entamoeba Histolytica
what is a pyogenic liver abscess
pocket of pus that forms in the liver due to bacterial infection
next steps for investigating + trx pyogenic liver abscess
1) blood cultures
2) image guided percutaneous drainage
3) broad spec abx
Hepatitis C is most commonly transmitted through
- IVDU
- reuse/inadequate sterilisation of injecting equipment
- transfusion of unscreened blood
incubation period of Hep C
2 weeks to 6 months
high prevalence areas for Hep C
- eastern Asia
- middle east
- northern Africa
acute phase Hep C symptoms
over 2/3 are asymptomatic in acute phase
symptoms of Hep C
- RUQ pain
- fever
- lethargy
- jaundice
- joint pain
- confusion
transmission of E.histolytica
faecal oral route
presentation of amoebic liver abscess
- RUQ pain
- fever
- diarrhoea
(jaundice is rare)
difference between amoebic and pyogenic abscesses
pyogenic abscesses tend to present multiple
aspiration of amoebic abscesses reveals…
sterile odourless brown fluid with thick anchovy paste consistency
trx amoebic abscess
metronidazole
what does HBsAg indicate
= hep b surface antigen
- acute disease is present for 1-6 months
- implies chronic disease if present for more than 6 monnhs
anti-HBs
= antibody to hepatitis B surface antigen
- implies immunity to Hep B
- Is negative in chronic disease
anti-HBc
= antibody to Hep B core antigen
- exposure to hep B virus
- will be negative if immunized
IgM anti-Hbc
appears during acute or recent hep b infection and present for about 6 months
