Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Alimentary System > Liver Symposium > Flashcards

Liver Symposium Flashcards

1
Q

what are the five main types of viruses that cause viral hepatitis?

A

A B C D E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what hep. viruses are enteric?

A

hep a and e

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

name three parenteral hep viruses

A

b, c and d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what hep viruses cause self limiting acute infections?

A

hep. a and e

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what hep. viruses cause chronic disease?

A

hep. b, c and d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how is hepatitis a transmitted?

A

> faecal oral
sexual
blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how is acute hep. a diagnosed?

A

by IgM antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

who is immunised against hep. a?

A 
> travellers
> patients with chronic liver disease
> haemophiliacs
> occupational exposure
> gay men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

does hepatitis b contain DNA or RNA?

A

DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what antigen is excreted by the hep. b virus?

A

e antigen: HBeAg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

in hep. b what antigens are detected and what does their presence mean?

A

> surface antigen (HBsAg) - shows virus is present
e-antigen - blood test shows active replication
core antigen (HBcAg) - detected only in a liver biopsy shows active replication
HBV DNA: active replication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the effect of the e antigen on the host?

A

it interferes with the hosts immune system preventing it form attacking to virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what do anti-HB’s provide?

A

protection form the HBV virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are IgM anti-HBc’s a sign of?

A

an acute HBV infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

in what sort of infection are IgG anti-HBc’s present?

A

chronic HBV infection/exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what antibodies will be present if the HBV virus is inactive?

A

anti-HBe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

describe the natural history of chronic hepatitis B

A

> no further progression (but increased risk of hepatocellular carcinoma) OR
cirrhosis can develop that then leads on to either end-stage liver disease or hepatocellular carcinoma (then ESLD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

is hep. c more likely to be a chronic infection or an acute infection?

A

chronic, 85% of cases are chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

why is hep. c not noticed until late infection?

A

the patient is normally asymptomatic until cirrhotic and the patient may have normal LFT’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

is hep. c a RNA virus or DNA virus?

A

RNA virus

21
Q

describe the natural history of hep. c

A

Exposure (acute phase) can be resolved or become chronic infection.
Chronic hep c then either stabilises or leads to cirrhosis. Cirrhosis can then either slowly progress/worsen or it may lead to HCC

22
Q

what hepatitis virus is a co-infection?

A

hepatitis d, it parasites onto the hep. b virus

23
Q

describe the hep. d virus

A

it is a small rna virus that does not code for its own protein coat so is enveloped by HBsAg.

24
Q

in what animal is hep e endemic?

A

pigs

25
Q

what is the commonest cause of acute hepatitis in Grampian?

A

hepatitis e

26
Q

is hep e self limiting?

A

yes

27
Q

name the three entities encompassed by non-alcoholic fatty liver disease

A

> simple steatosis
non-alcoholic steatohepatitis
fibrosis and cirrhosis

28
Q

what are the metabolic syndrome risk factors associated with NAFLD?

A

> diabetes mellitus
obesity
hypertriglyceridemia
hypertension

29
Q

what are the risk factors for non-alcohol fatty liver disease?

A

> age
ethnicity (Hispanic)
genetic factors (PNPLA3 gene)

30
Q

describe the natural history of NAFLD

A

Steatosis of the normal liver, of which 12-40% go on to develop NASH +/- fibrosis. Then around 15% of them go on to develop cirrhosis.

31
Q

in the NAFLD scoring system how many categories are the patients positive for when they are classed as high risk?

A

3 or more

32
Q

what treatment can be given for non-alcohol fatty liver disease?

A 
> diet, weight reduction and exercise
> insulin sensitizers
> glucagon-like peptide 1 analogues
> farnesoid x nuclear receptor ligand
> vitamin e
33
Q

what are the main autoimmune disease of the liver?

A 
> autoimmune hepatitis
> primary biliary cholangitis
> primary sclerosing cholangitis
> (autoimmune cholangiopathy)
> (IgG 4 disease)
34
Q

what antibody is elevated in autoimmune hepatitis?

A

IgG

35
Q

what three types of antibodies are relevant to autoimmune hepatitis?

A

Type 1: ANA, SMA
Type 2: LKM1
Type 3: SLA

36
Q

what treatment is given to autoimmune hepatitis?

A

> steroids

> long term azathioprine

37
Q

what antibodies are elevated in primary biliary cholangitis?

A

IgM

38
Q

what symptoms are common in primary biliary cholangitis?

A

pruritus and fatigue

39
Q

is primary biliary cholangitis anti-mitochondrial antibody positive or negative?

A

positive

40
Q

what is the treatment of choice for primary biliary cholangitis?

A

UDCA (ursideoxycholic acid)

41
Q

what bile ducts are involved in primary sclerosing cholangitis?

A

the intra and extrahepatic bile ducts

42
Q

what sort of disease is primary sclerosing cholangitis?

A

a stricturing disease

43
Q

what can recurrent cholangitis lead to?

A

jaundice

44
Q

what is the only treatment for primary sclerosing cholangitis

A

liver transplant

45
Q

when can you transplant?

A

> chronic liver disease with poor predicted survival
chronic liver disease with associated poor quality of life
hepatocellular carcinoma
acute liver failure
genetic diseases

46
Q

what are the contraindications for transplant?

A 
> active extraheptic malignancy
> hepatic malignancy with diffuse tumour invasion
> uncontrolled infection outside hepatobiliary system
> alcohol or substance abuse
> comorbid conditions
> psychosocial factors
> anatomical barriers
> brain death
47
Q

what two scoring systems are used to prioritise liver transplant in cirrhosis?

A

> MELD score - bilirubin, creatinine and inr

> UKELD - bilirubin, sodium, creatinine and inr

48
Q

what is post operative treatment for liver transplant?

A 
> prophylactic antibiotics
> anti fungal drugs
> anti rejection drugs:
steroids
azathioprine
tacrolimus
49
Q

What criteria is the NAFLD score based on?

A

Age, presence of DM (or impaired fasting glucose), BMI, AST/ALT ratio, platelet count, and albumin

Alimentary System (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions