PATHOPHYS

Question 1

what are the only 2 hepatitis viruses that can cause acute hepatitis?

Answer 1

HAV, HEV

Question 2

which hepatitis causes a more severe illness in pregnant women & elderly?

Answer 2

HEV

Question 3

HAV, HBV vaccination should be given to all pts with what?

Answer 3

chronic liver disease

Question 4

which 2 types of hepatitis viruses cause chronic hepatitis?

Answer 4

HBV, HCV

Question 5

_________ (chronic hepatitis) can be effectively suppressed by current treatment, but cure is rare

Answer 5

HBV

Question 6

which type of chronic hepatitis can be cured in a large percentage of pts?

Answer 6

HCV

Question 7

which genotype of HCV is the hardest to cure?

Answer 7

Genotype 1 of HCV

Question 8

all HBV pts should be screened for what?

Answer 8

HCC

Question 9

if you have HCV and cirrhosis you should be screened for what?

Answer 9

HCC

Question 10

what is the MCC of chronic liver dz in the US?

Answer 10

HCV

Question 11

what is the 2nd MCC of chronic liver dz in the US?

Answer 11

Alcohol

Question 12

what is the 3rd MCC of chronic liver dz in US?

Answer 12

NAFLD

Question 13

what are the 2 most important environmental factors determining alcoholic liver disease risk?

Answer 13

ethanol & obesity

Question 14

what is the genetic defect in hemochromatosis?

Answer 14

defective HFE gene (C282Y) on chromosome 6

unregulated Fe absorption in small intestine

Question 15

what is the genetic defect in wilson’s disease?

Answer 15

ATPase enzyme (ATP7B gene) on chromosome 13
decreased loading of copper onto ceruloplasmin

Question 16

what is the genetic defect in alpha1-antitrypsin deficiency?

Answer 16

failure to secrete alpha1-antitrypsin protein (chromosome 14), has abnormally folded molecule that gets stuck in liver cells and can’t get to lung and serum

Question 17

what is the screening test for hemochromatosis?

Answer 17

transferrin saturation

Question 18

what is the screening test for wilson’s disease?

Answer 18

ceruloplasmin and free copper levels

Question 19

what is the screening test for alpha1-antitrypsindeficiency?

Answer 19

alpha1-antitrypsin phenotype

Question 20

how do you diagnose hemochromatosis?

Answer 20

gene test (C282Y) mutation of HFE gene on chromosome 6

Question 21

how do you diagnose wilson’s disease?

Answer 21

liver biopsy

Question 22

how do you diagnose alpha1-antitrypsin deficiency?

Answer 22

liver biopsy

Question 23

what is the main organ problem in hemochromatosis?

Answer 23

cirrhosis of liver

Question 24

what is the main organ problem in wilson’s disease?

Answer 24

cirrhosis and fulminant liver failure

Question 25

what is the main organ problem in alpha1-antitrypsin deficiency?

Answer 25

cirrhosis of the liver

Question 26

what is the most common cause of cirrhosis?

Answer 26

alcoholic liver disease

Question 27

what is the most common cause of liver cirrhosis in children?

Answer 27

alpha1-antitrypsin deficiency

Question 28

name of pathology in liver dz with lack of return of renal function with intravascular volume repletion

Answer 28

hepatorenal syndrome

Question 29

what are the components of the child pugh score?

Answer 29

``` albumin biirubin ascites encephalopathy PT/INR ```

Question 30

what are the components of MELD?

Answer 30

INR Bilirubin creatinine

Question 31

what is the child pugh score used for?

Answer 31

can be used to determine prognosis after variceal bleeding

Question 32

what is the MELD score used for?

Answer 32

prognostic & preoperative sign, factor for transplant