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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
Which Hep infection is most likely to progress to cirrhosis or carcinoma?
C (C for Cirrhosis and Carcinoma)
26
If a patient is recovering from Hep B, what serologic markers would you expect to see?
Antibody to hep B surface antigen Hep B early antibody IgG antibody to Hep B core antigen
27
What color would you expect urine to be in patient with Hep A?
Dark
28
Which Hep viruses cannot be destroyed by the gut?
A and E (“naked viruses”)
29
Patients receiving needle injections at hospitals are possibly at risk for Hep _____and _____.
B or C
30
Granular eosinophilia “ground glass” appearance o the liver on biopsy is seen in Hep ____ and _____
D and B
31
IV drugs and ____are most common transmissions of hep C.
Blood transfusion
32
Newborns with Hep B have a high chance of developing (Acute/Chronic) infection.
Chronic
33
What would the Hep B e antigen indicate?
Active viral replication, high transmissibility, poor prognosis (BAD!)
34
Hep B has a (long/short) incubation period.
Long
35
Hep A has a (Long/Short) incubation period.
Short
36
A patient presents with purple, prurience, polygonal planar papules and plaques. She most likely has Hep____.
C
37
Patients with hep C have an increased risk for hypothyroidism and _______.
Diabetes mellitus
38
Hep E has a (long/short) incubation period
Short
39
A patient presents with joint pain, fever, and a rash. This is most likely Hep _______
B
40
Do most Hep B pt’s recover?
Yes
41
Hep C has a (short/long) recovery period?
Long
42
IgM marks _________infection in Hep A.
Active
43
Tx for Hep E is generally ____
Supportive
44
Which type of bilirubin can be excreted by the kidney?
Conjugated (water soluble)
45
What is a normal value of total serum bilirubin? (95% pop.)
1-1.5mg/dL
46
What does elevated conjugated hyperbilirubinemia indicate?
Liver or biliary tract disease
47
In a patient with significant muscle wasting from advanced liver disease, what might you expect to see in the blood sample?
High blood ammonia (liver is not able to detoxify ammonia and convert it to urea)
48
What type of enzymes are most helpful in recognizing acute hepatocellular diseases such as hepatitis?
Aminostranferases (ALT and AST)
49
This enzyme is primarily found in the liver and is a more specific indicator of liver injury (ALT or AST)?
ALT (L for LIVER)
50
What is the “general” normal range for aminotransferases?
10-40 IU/L
51
In acute hepatocellular disorders ______is generally higher than or equal to the ______.
ALT | AST
52
An AST: ALT ratio of ________is suggestive of alcoholic liver disease.
2: 1 | * 3:1 highly suggestive
53
Serum albumin is synthesized by _______
Hepatocytes
54
Serum albumin has a _____half-life: ______days.
Long: 18-20
55
Why is the serum y globulin increased in cirrhosis?
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
Increases in IgA levels usually occur in _________
A for Alcoholic liver disease
57
Increases in IgM levels are common in ________
Primary biliary cirrhosis
58
Where are blood clotting factors generally made?
Hepatocytes
59
Are the serum half-lives of coagulation factors shorter or longer than albumin?
Shorter
60
What is the single best acute measure of hepatic synthetic function?
Coagulation Factor
61
Biosynthesis of factors II, VII, and X depends on vitamin _____
K
62
What is the first diagnostic test for patients whose liver tests suggest cholestasis?
Ultrasonography
63
What test would you use to distinguish between cystic and solid masses in the liver?
Ultrasound
64
Which of the Hep virus’s is a DNA virus?
Hep B (But replicates like a retrovirus)
65
Hep A incubation period.
4 weeks
66
When could you detect antibodies to HAV?
During the acute illness when serum aminotransferase is elevated and fecal HAV is still occurring. (3 mo)
67
After a person is infected with HBV what is the first detectable virologist marker?
HBsAg | *undetectable after jaundice
68
A common cause of Hepatitis in India, Asia, Africa, and Central America
Hep E.
69
Marked cholestasis is a common histology feature in Hep_____
E *Bile can’t flow thru
70
HDV infection in the US is generally contracted via________
Blood and blood products | *Drug users
71
Hep ______is the most frequent indication for liver transplantation.
C
72
A diagnosis of Hep A is based on detection of ______anti-HAV during acute illness
IgM
73
What would you see in a blood test of someone with the Hep B vaccine?
Anti-HBs
74
If a patient presents with ascites, low serum albumin level, hypoglycemia and very high serum bilirubin what should you do?
Hospital admission asap!! *Severe hepatocellular disease
75
The most feared complication of viral hepatitis.
Fulminant hepatitis (massive hepatic necrosis) *RARE!
76
Who is at most risk for chronic infection after acute HBV infection?
Neonates Down’s syndrome Immunosuppressed (HIV)
77
Is full recovery likely in previously healthy adults with Hep B?
Yes, 99%
78
Tx for Hep C
24 week course of long-acting pegylated interferon + ribavarin
79
Med for severe pruritus (itching).
Cholestyeramine
80
Vaccines are available for Hep____,______, and ______.
Hep A, B, and E
81
The most common cause of acute liver failure.
Drug-induced liver injury
82
What drug is the most prevalent cause of acute liver failure in the west?
Acetaminophen
83
Tx for acetaminophen overdosage
Gastric lavage Supportive measures Activated charcoal (Or cholestyramine)
84
Most common agent implicated as causing drug-induced liver injury in the US :
Amoxicillin-Clavulanate
85
The most common chronic liver disease in the US
Nonalcoholic fatty liver disease

FUN MED SPRING 2018 (14 decks)

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