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FUN MED SPRING 2018 > 8. Liver 1 > Flashcards

8. Liver 1 Flashcards

1
Q

Hep A Transmission

A

Fecal-Oral

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2
Q

Is Hep A generally acute or chronic?

A

Acute

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3
Q

What does the HAV IgM antibody tell us?

A

Active disease of Hep A

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4
Q

Hep E. Transmission

A

Fecal-Oral

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5
Q

Is there a vaccine for HEV?

A

No

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6
Q

Which type of Hep. can lead to acute liver failure in pregnancy: HAV or HEV?

A

HEV

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7
Q

Hep C Transmission

A

Blood (sex, childbirth)

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8
Q

Gold standard tests for diagnosing HCV

A

HCV RNA test (with PCR)-can detect viral RNA in blood.

If RNA decrease-recovery
If RNA same-chronic HCV

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9
Q

Hep B Transmission

A

Blood (childbirth and sex)

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10
Q

Who is most likely to get chronic infection of HBV?

A

Children under 6

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11
Q

Which type of Hep is most likely linked to liver cancer?

A

HBV

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12
Q

What does it mean if you see IgG antibodies in a patient with HBV?

A

Recovery

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13
Q

What does the HBe antigen tell us in HBV?

A

It is an active infection that is replicating

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14
Q

What do we expect to see during the onset of infection during the acute phase of HBV?

A

HBsAg (Hepatitis B surface Antigen)

IgM antibodies attacking the core antigens

IgG antibodies

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15
Q

What is needed to overcome HBV?

A

IgG

IgM can convert to IgG

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16
Q

Hep D needs what to infect a host?

A

HBV

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17
Q

In HDV, if the HDV IgM or IgG are present, what does this mean?

A

Active Infection

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18
Q

What would you expect to see on a liver biopsy of Hep B?

A

Granular eosinophilia “ground glass” appearance;cytotoxic T-cells mediated damage

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19
Q

Hepatocytes swelling, monocytes infiltration, and Councilman bodies are all seen in Hep ____ biopsy

A

A

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20
Q

Interferon-alpha is used to treat chronic Hep __ and ____.

A

B and C

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21
Q

Carrier state is common in Hep ____and _____.

A

B and C

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22
Q

(IgM/IgG) antibody to hep B core antigen means there is an acute/recent infection of hep B virus.

A

IgM

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23
Q

What would you give to a baby born to a mother with active hep B?

A

Anti-hepatitis B immunoglobulin

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24
Q

Which Hep virus can cause liver failure in pregnant mothers?

A

E (E for expectant mothers)

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25
Q

Which Hep infection is most likely to progress to cirrhosis or carcinoma?

A

C (C for Cirrhosis and Carcinoma)

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26
Q

If a patient is recovering from Hep B, what serologic markers would you expect to see?

A

Antibody to hep B surface antigen

Hep B early antibody

IgG antibody to Hep B core antigen

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27
Q

What color would you expect urine to be in patient with Hep A?

A

Dark

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28
Q

Which Hep viruses cannot be destroyed by the gut?

A

A and E (“naked viruses”)

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29
Q

Patients receiving needle injections at hospitals are possibly at risk for Hep _____and _____.

A

B or C

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30
Q

Granular eosinophilia “ground glass” appearance o the liver on biopsy is seen in Hep ____ and _____

A

D and B

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31
Q

IV drugs and ____are most common transmissions of hep C.

A

Blood transfusion

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32
Q

Newborns with Hep B have a high chance of developing (Acute/Chronic) infection.

A

Chronic

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33
Q

What would the Hep B e antigen indicate?

A

Active viral replication, high transmissibility, poor prognosis (BAD!)

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34
Q

Hep B has a (long/short) incubation period.

A

Long

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35
Q

Hep A has a (Long/Short) incubation period.

A

Short

36
Q

A patient presents with purple, prurience, polygonal planar papules and plaques. She most likely has Hep____.

A

C

37
Q

Patients with hep C have an increased risk for hypothyroidism and _______.

A

Diabetes mellitus

38
Q

Hep E has a (long/short) incubation period

A

Short

39
Q

A patient presents with joint pain, fever, and a rash. This is most likely Hep _______

A

B

40
Q

Do most Hep B pt’s recover?

A

Yes

41
Q

Hep C has a (short/long) recovery period?

A

Long

42
Q

IgM marks _________infection in Hep A.

A

Active

43
Q

Tx for Hep E is generally ____

A

Supportive

44
Q

Which type of bilirubin can be excreted by the kidney?

A

Conjugated (water soluble)

45
Q

What is a normal value of total serum bilirubin? (95% pop.)

A

1-1.5mg/dL

46
Q

What does elevated conjugated hyperbilirubinemia indicate?

A

Liver or biliary tract disease

47
Q

In a patient with significant muscle wasting from advanced liver disease, what might you expect to see in the blood sample?

A

High blood ammonia (liver is not able to detoxify ammonia and convert it to urea)

48
Q

What type of enzymes are most helpful in recognizing acute hepatocellular diseases such as hepatitis?

A

Aminostranferases (ALT and AST)

49
Q

This enzyme is primarily found in the liver and is a more specific indicator of liver injury (ALT or AST)?

A

ALT (L for LIVER)

50
Q

What is the “general” normal range for aminotransferases?

A

10-40 IU/L

51
Q

In acute hepatocellular disorders ______is generally higher than or equal to the ______.

A

ALT

AST

52
Q

An AST: ALT ratio of ________is suggestive of alcoholic liver disease.

A

2: 1

* 3:1 highly suggestive

53
Q

Serum albumin is synthesized by _______

A

Hepatocytes

54
Q

Serum albumin has a _____half-life: ______days.

A

Long: 18-20

55
Q

Why is the serum y globulin increased in cirrhosis?

A

Increased synthesis of antibodies which are directed against intestinal bacteria

*because the cirrhosis liver fails to clear bacterial antigens that normally reach the liver through the hepatic circulation.

56
Q

Increases in IgA levels usually occur in _________

A

A for Alcoholic liver disease

57
Q

Increases in IgM levels are common in ________

A

Primary biliary cirrhosis

58
Q

Where are blood clotting factors generally made?

A

Hepatocytes

59
Q

Are the serum half-lives of coagulation factors shorter or longer than albumin?

A

Shorter

60
Q

What is the single best acute measure of hepatic synthetic function?

A

Coagulation Factor

61
Q

Biosynthesis of factors II, VII, and X depends on vitamin _____

A

K

62
Q

What is the first diagnostic test for patients whose liver tests suggest cholestasis?

A

Ultrasonography

63
Q

What test would you use to distinguish between cystic and solid masses in the liver?

A

Ultrasound

64
Q

Which of the Hep virus’s is a DNA virus?

A

Hep B (But replicates like a retrovirus)

65
Q

Hep A incubation period.

A

4 weeks

66
Q

When could you detect antibodies to HAV?

A

During the acute illness when serum aminotransferase is elevated and fecal HAV is still occurring. (3 mo)

67
Q

After a person is infected with HBV what is the first detectable virologist marker?

A

HBsAg

*undetectable after jaundice

68
Q

A common cause of Hepatitis in India, Asia, Africa, and Central America

A

Hep E.

69
Q

Marked cholestasis is a common histology feature in Hep_____

A

E

*Bile can’t flow thru

70
Q

HDV infection in the US is generally contracted via________

A

Blood and blood products

*Drug users

71
Q

Hep ______is the most frequent indication for liver transplantation.

A

C

72
Q

A diagnosis of Hep A is based on detection of ______anti-HAV during acute illness

A

IgM

73
Q

What would you see in a blood test of someone with the Hep B vaccine?

A

Anti-HBs

74
Q

If a patient presents with ascites, low serum albumin level, hypoglycemia and very high serum bilirubin what should you do?

A

Hospital admission asap!!

*Severe hepatocellular disease

75
Q

The most feared complication of viral hepatitis.

A

Fulminant hepatitis (massive hepatic necrosis)

*RARE!

76
Q

Who is at most risk for chronic infection after acute HBV infection?

A

Neonates
Down’s syndrome
Immunosuppressed (HIV)

77
Q

Is full recovery likely in previously healthy adults with Hep B?

A

Yes, 99%

78
Q

Tx for Hep C

A

24 week course of long-acting pegylated interferon + ribavarin

79
Q

Med for severe pruritus (itching).

A

Cholestyeramine

80
Q

Vaccines are available for Hep____,______, and ______.

A

Hep A, B, and E

81
Q

The most common cause of acute liver failure.

A

Drug-induced liver injury

82
Q

What drug is the most prevalent cause of acute liver failure in the west?

A

Acetaminophen

83
Q

Tx for acetaminophen overdosage

A

Gastric lavage
Supportive measures
Activated charcoal (Or cholestyramine)

84
Q

Most common agent implicated as causing drug-induced liver injury in the US :

A

Amoxicillin-Clavulanate

85
Q

The most common chronic liver disease in the US

A

Nonalcoholic fatty liver disease

FUN MED SPRING 2018 (14 decks)

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