24: Acute Hepatitis, Liver Failure

Question 1

Nomogram for calculating acetaminophen level over time

Answer 1

Rumack-Matthew Nomogram

Question 2

AST/ALT can rise above what level in acetaminophen toxicity?

Answer 2

5000 u/L

Question 3

What is a unique sign pointing to viral hepatitis

Answer 3

Aversion to smoking

Question 4

Risk of perinatal Hep B transmission

Answer 4

90%

Question 5

Window period in Hepatitis B

Answer 5

Between HBsAg disappearing -> HBsAb appearing

Question 6

Prevention in pt with viral hep C

Answer 6

Vaccinate against HAV and HBV

Question 7

Five prevention techniques with hepatitis C

Answer 7

1. Test donated blood
2. Baby boomers should all be tested
3. All people over 18 should be tested at least once in their life
4. HCV infected persons should practice safe sex
5. HCV infected persons should not share razors or toothbrush

Question 8

What drug given to transplant pts with HEV can cause cirrhosis

Answer 8

Tacrolimus

Question 9

Drugs that can cause dose-dependent vs idiosyncratic DILI

Answer 9

Dose-dependent: poisonous mushrooms, Tylenol

Idiosyncratic: isoniazid, halothane, phenytoin, methyldopa, carbamazepine, diclofenac, oxacillin, sulfonamides

Question 10

Amount of acetaminophen considered appropriate for a healthy person vs in pt with liver disease

Answer 10

1. Healthy: 3g/24hrs

2. Liver dz: 2g/24hrs

Question 11

Critical ingestion treatment interval for max protection with acetaminophen OD

Answer 11

0-8 hours

Question 12

How many hours do you plot on a Rumack-Matthew Nomogram

Answer 12

4-24hrs