Acute Viral Hepatitis + Chronic Liver Disease Flashcards

1
Q

systemic infection affecting the liver predominantly

A

Acute viral hepatitis

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2
Q

Incubation period is 15–45 days

A

Hepatitis A

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3
Q

Incubation period is 30–180days

A

hepatitis B and D

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4
Q

Incubation period is 15–160days

A

hepatitis C

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5
Q

Incubation period is 14–60 days

A

hepatitis E

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6
Q

Non specific symptoms

Anorexia, nausea and vomiting, fatigue, malaise, arthralgias, myalgias, headache, photophobia, pharyngitis, cough, and coryza
low-grade fever
Dark urine

A

Prodromal symptoms

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7
Q

more often present in hepatitis A and E than in hepatitis B or C

A

low-grade fever between 38° and 39°C (100°–102°F)

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8
Q

may be noticed by the patient from 1–5 days before the onset of clinical jaundice

A

Dark urine

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9
Q

precede the onset of jaundice by 1–2 weeks

A

Prodromal symptoms
Non specific

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10
Q

Jaundice is evident in this phase

A

Clinical jaundice / icteric phase

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11
Q

liver becomes enlarged and tender and may be associated with right upper quadrant pain and discomfort
Splenomegaly and cervical adenopathy

A

Clinical jaundice phase

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12
Q

Splenomegaly and cervical adenopathy are present in

A

10–20% of patients with acute hepatitis

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13
Q

constitutional symptoms disappear, but the liver may still be enlarged

A

Recovery phase

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14
Q

duration of this phase is variable, ranging from 2–12 weeks, and is usually more prolonged in acute hepatitis B & C

A

Recovery phase

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15
Q

clinical recovery is expected in all hepatitis A and E is in ……

A

1–2 months

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16
Q

clinical recovery is expected in in three-quarters of hepatitis B and C is in ……

A

3–4 months

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17
Q

Progressive destruction and regeneration of the liver parenchyma leading to fibrosis or cirrhosis for a period of more than 6 months

A

Chronic Liver Disease CLD

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18
Q

consists of (one or more):
Inflammation (chronic hepatitis)
Liver cirrhosis
Hepatocellular carcinoma.

A

Chronic Liver Disease CLD

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19
Q

Chronic Liver Disease CLD consists of (one or more)

A

Inflammation (chronic hepatitis)
Liver cirrhosis
Hepatocellular carcinoma

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20
Q

Development of liver fibrosis to the point that there is architectural distortion of liver parenchyma with the formation of regenerative nodules

A

Liver cirrhosis

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21
Q

Alcoholism

A

Main Cause of Cirrhosis

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22
Q

Chronic viral hepatitis
Hepatitis B
Hepatitis C

A

Main Cause of Cirrhosis

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23
Q

Nonalcoholic fatty liver disease (NAFLD)

A

Main Cause of Cirrhosis

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24
Q

nonalcoholic steatohepatitis (NASH)

A

Main Cause of Cirrhosis

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25
Q

Autoimmune hepatitis

A

Main Cause of Cirrhosis

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26
Q

Cardiac cirrhosis

A

Less Common Cause of Cirrhosis

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27
Q

Hemochromatosis

A

Inherited metabolic liver disease

Less Common Cause of Cirrhosis

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28
Q

Cystic fibrosis

A

Inherited metabolic liver disease

Less Common Cause of Cirrhosis

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29
Q

α1 Antitrypsin deficiency

A

Inherited metabolic liver disease

Less Common Cause of Cirrhosis

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30
Q

Wilson’s disease

A

Inherited metabolic liver disease

Less Common Cause of Cirrhosis

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31
Q

Primary biliary cirrhosis

A

Biliary cirrhosis

Less Common Cause of Cirrhosis

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32
Q

Primary sclerosing cholangitis

A

Biliary cirrhosis

Less Common Cause of Cirrhosis

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33
Q

Autoimmune cholangiopathy

A

Biliary cirrhosis

Less Common Cause of Cirrhosis

34
Q

Cryptogenic cirrhosis

A

Less Common Cause of Cirrhosis

35
Q

usually well advanced before its symptoms are noticeable enough to cause alarm

A

Liver cirrhosis

36
Q

nonspecific, weakness, fatigue, anorexia and weight loss are

A

earliest and commonest symptoms

37
Q

yellow discoloration of the skin
and mucous membranes (with the eye being especially noticeable) due to increased bilirubin

A

Jaundice

38
Q

vascular lesions consisting of a central arteriole surrounded by many smaller vessels and occur due to an increase in estradiol

A

Spider angiomata or spider nevi

39
Q

due to increased bilirubin

A

Jaundice

40
Q

due to an increase in estradiol

A

Spider angiomata or spider nevi
+ Gynecomastia

41
Q

reddening of palms at the thenar and hypothenar eminences also as a result of increased estrogen

A

Palmar erythema

42
Q

result of increased estrogen

A

Palmar erythema

43
Q

angle between the nail plate and proximal nail fold > 180 degrees

A

Clubbing

44
Q

Thickening and shortening of palmar fascia that leads to flexion deformities of the fingers

A

Dupuytren’s contracture

45
Q

resulting from decreased production
of coagulation factors

A

Bruising and bleeding

46
Q

bilateral asynchronous flapping of outstretched, dorsiflexed hands seen in patients with hepatic encephalopathy

A

Asterixis (Flapping tremor)

47
Q

Increase in breast gland size in men that is not cancerous, is caused by increased estradiol

A

Gynecomastia

48
Q

decrease in sex hormones manifest as impotence, infertility, loss of sexual drive, and testicular atrophy, can result from primary gonadal injury or suppression of hypothalamic/pituitary function

A

Hypogonadism

49
Q

result from primary gonadal injury or suppression of hypothalamic/pituitary function

A

Hypogonadism

50
Q

In people with cirrhosis
Liver size can be ….

A

enlarged, normal, or shrunken

51
Q

musty breath odor resulting from increased dimethyl sulfide

A

Fetor hepaticus

52
Q

resulting from increased dimethyl sulfide

A

Fetor hepaticus

53
Q

Indicates advanced liver disease

A

Fetor hepaticus

54
Q

Accumulation of fluid in the peritoneal cavity

A

Ascites

55
Q

dilated periumbilical collateral veins due to portal hypertension

A

Caput medusa

56
Q

due to portal hypertension

A

Caput medusa

57
Q

increases resistance to blood flow and higher pressure in the portal venous system, resulting in portal hypertension

A

Liver cirrhosis

58
Q

Effects of portal hypertension include

A

Splenomegaly

Esophageal varices

Hepatic encephalopathy

59
Q

found in 35% to 50% of patients

A

Splenomegaly

60
Q

result from collateral portal blood flow through vessels in the stomach and esophagus

A

Esophageal varices

61
Q

When these blood vessels become enlarged, they are called

A

varices

62
Q

liver does not clear ammonia and related nitrogenous substances from the blood, which are carried to the brain, affecting cerebral functioning

A

Hepatic encephalopathy

63
Q

The symptoms may range from mild to severe and may be observed in as many as 70% of patients with cirrhosis

A

Hepatic encephalopathy

64
Q

Grading of hepatic Encephalopathy
Based on

A

West Haven
State of consciousness

65
Q

No change in personality or behavior
No asterixis (flapping tremor)

A

Stage 0
of hepatic Encephalopathy
Normal

66
Q

Impaired concentration + attention span
Sleep disturbance, slurred speech
Euphoria or depression
Asterixis present

A

Stage 1
of hepatic encephalopathy

67
Q

Lethargy, drowsiness,apathy or aggression
Disorientation, inappropriate behavior, slurred speech

A

Stage 2
of hepatic Encephalopathy

68
Q

Confusion + disorientation, bizarre behavior
Drowsiness or stupor
Asterixis usually absent

A

Stage 3
of hepatic Encephalopathy

69
Q

Comatose with no response to voice commands
Minimal or absent response to painful stimuli

A

Stage 4
of hepatic Encephalopathy

70
Q

Jaundice

A

Clinical Feature of Chronic Liver Disease / cirrhosis

71
Q

Spider angiomata or spider nevi

A

Clinical Feature of Chronic Liver Disease / cirrhosis

72
Q

Palmar erythema

A

Clinical Feature of Chronic Liver Disease / cirrhosis

73
Q

Clubbing

A

Clinical Feature of Chronic Liver Disease / cirrhosis

74
Q

Dupuytren’s contracture

A

Specific

Clinical Feature of Chronic Liver Disease / cirrhosis

75
Q

Bruising and bleeding

A

Clinical Feature of Chronic Liver Disease / cirrhosis

76
Q

Asterixis

A

Flapping tremor

77
Q

Asterixis (Flapping tremor)

A

Clinical Feature of Chronic Liver Disease / cirrhosis

78
Q

Gynecomastia

A

Clinical Feature of Chronic Liver Disease / cirrhosis

79
Q

Hypogonadism

A

Clinical Feature of Chronic Liver Disease / cirrhosis

80
Q

Fetor hepaticus

A

Clinical Feature of Chronic Liver Disease / cirrhosis

81
Q

Ascites

A

Clinical Feature of Chronic Liver Disease / cirrhosis

82
Q

Caput medusa

A

Clinical Feature of Chronic Liver Disease / cirrhosis