Diagnostic Tests

Question 1

Bilirubin 2-3 mg/dl

Answer 1

Jaundice

Question 2

Hepatitis symtoms > 6 months

Answer 2

Chronic hepatitis

Question 3

Why do you do liver biopsy?

Answer 3

• determining etiology

- Assessing degree of liver damage

Question 4

Treatment of newborns to HBsAg positive mothers?

Answer 4

HBIG
Hep B vaccine

with-in 2-12 hours after birth

Question 5

Primary Biliary Cirrhosis

Answer 5

AMA = Circulating anti-mitchondrial antibodies

Question 6

Primary sclerosing cholangitis

Answer 6

p-ANCA

beading appearance on cholangiogram

Question 7

Elevated Alk. Phos.

Elevated GGT

Answer 7

Cholestatic injury pattern

Question 8

HFE mutation (C282Y)

Answer 8

Hereditary Hemochromatosis

Question 9

Hereditary Hemochormatosis

Answer 9

Fasting transferrin saturation

Question 10

Distinguishing primary and secondary hemochromatosis

Answer 10

Secondary- iron initially accumulates in Kupffer cells, not in hepatoctes

Question 11

Wilson’s Disease

Answer 11

Low ceruloplasmin

Elevated 24 urine copper excretion

Question 12

Mutation in ATP7B gene

Answer 12

Wilson’s Disease

Question 13

When should you consider Wilson’s disease in a differential diagnosis?

Answer 13

Liver disease in anyone

Question 14

Kayser-Fleischer rings

Answer 14

Wilson disease

*ring copper deposits at limbus of cornea

Question 15

PAS + globules in liver

Answer 15

A1AT Deficiency

• misfolded gene product protein aggregates in hepatocellular ER
• Note different pathogenesis than lungs!!!!

Question 16

Autoimmune Hepatitis

Answer 16

ANA, anti-smooth muscle antibodies

Question 17

Elevated AST, ALT

Answer 17

Establish presence of hepatocellular damage

Question 18

AST > ALT

Answer 18

Alcoholic liver disease

Question 19

Which is more specific for liver, AST or ALT?

Answer 19

ALT!

Question 20

What measures global hepatic synthesis? (function)

Answer 20

Albumin
PT
Clotting factors (Factor V)

Question 21

Ground glass hepatocytes

Answer 21

Chronic viral hepatits B

Question 22

Lymphocytic/ granulomatous cholangitis

Answer 22

PBC

Question 23

Fibrous obliterative cholangitis

Answer 23

Primary sclerosing cholangitis

Question 24

Periportal hepatitis with mild steatosis

Answer 24

Chronic viral hepatits C