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GI 2 Final AH > Diseases Of The Liver - McGowan > Flashcards

Diseases Of The Liver - McGowan Flashcards

1
Q

What HepB serology shows prior infection?

A

HBsAg
HBcAb IgG
HBeAb may or may not be present

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2
Q

What has a SAAG score of greater than 1.1?

A

hepatic congestion
Liver disease
Portal vein occlusion

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3
Q

What laundry list are complications for HCV?

A

Mixed cryoglobulinemia
Membranoproliferative GN
Increased risk non-Hodgkin lymphoma
genotype 3 –> hepatic steatosis

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4
Q

What causes 50% of HCV cases?

What are RFs?

A

IV drug use

Body piercing, tattoo, hemodialysis, blood transfusion

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5
Q

Is AST or ALT more specific for liver injury?

A

ALT

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6
Q

What weird substances can cause fatty liver?

A

Vinyl chloride
Carbon tetrachloride
Yellow phosphorus

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7
Q

Wilson’s affects what chromosome and gene?
What inheritance?

Treat how?

A

Ch. 13 ATP7B
AR

Oral penicillamine, liver transplant

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8
Q

Who is at risk for HBV?

Delivery method?

A

Prisoners, STI people

blood, sex, mother-to-baby delivery

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9
Q

In alcoholic liver disease, what can precipitate Wernicke-Korsakoff syndrome?

A

Glucose admin if thiamine is not co-admin’ed

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10
Q

What are RFs for chronic liver disease?

A 
EtOH
Transfusions
Tattoos
IVDU
Viral hepatitis
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11
Q

IgM acute or chronic?

IgG?

A

Acute

Chronic

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12
Q

How do you diagnose HAV?

What do vaccinated pts show?

A

IgM anti-HAV

IgG anti-HAV

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13
Q

What has a SAAG score less than 1.1?

A 
Hypoalbuminemia
Anything w/ascites
Ovarian disease
Infections/peritonitis 
Malignant conditions
Mediterranean fever
Vasculitis
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14
Q

Hemochromatosis has increased iron absorption from where?

Iron accumulates where?

Treatment?

A

Duodenum

Heart, liver, pancreas, adrenals, testis, pituitary

Phlebotomy

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15
Q

What imaging would you want to do on someone with ascites and liver issues?

Why?

A

EGD

Looking for esophageal varices

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16
Q

Where is chronic HBV endemic?

Confers risk of what?

A

Asia
sub-Saharan Africa

HCC, cirrhosis

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17
Q

What medication association does HEV have?

A

Tacrolimus for immunosuppression from transplant

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18
Q

What drug and vitamin are associated with fibrosis and cirrhosis of the liver?

A

Methotrexate and Vitamin A

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19
Q

What meld score corresponds with class C child-pugh?

A

10-15

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20
Q

What HLA associations seen in PBC?

RFs?

Tx how?

A

DRB1 08 and DQB1

UTI, smoking, HRT, hair dye

Ursodeoxycholic acid

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21
Q

RUQ pain and tenderness, ascites, HSM, and jaundice indicates what?

A

Budd-Chiari

22
Q

+anti-HCV but -HCV RNA means what?

A

Recovery from past infection

23
Q

What meld score corresponds with class B child-pugh?

A

7-9

24
Q

What condition is associated with severe memory issues and confabulate (make-up stories)?

A

Korsakoff syndrome

25
Q

Pts with a Maddrey DF score above 32 have what?

Those with lower scores?

A

High short-term mortality, tx w/glucocorticoids can help

Low short-term mortality, don’t need glucocorticoids

26
Q

Formula for SAAG?

A

Serum albumin - ascitic fluid albumin

27
Q

What does the Glasgow alcoholic hepatitis score predict?

Those with a score greater than or equal to 9 had what?

Less than 9?

A

Mortality in alcoholic hepatitis

Received glucocorticoids had higher survival rates compared to those who didnt

NO survival benefit

28
Q

What do the labs in cirrhosis reveal?

A

Macrocytic anemia
Dec WBC
Thrombocytopenia
Inc PT time

29
Q

What is the major cause of acute hepatitis in central and SE Asia, Middle East, and North Africa?

Spread how?

A

HEV

Swine, waterborne

30
Q

Which child-pugh class has the worst prognosis?

A

C

31
Q

What grade is the following on the hepatic encephalopathy grading scale?

Somnolence to semistupor, responsive to verbal stimuli
Confusion
Gross disorientation, bizarre behavior

A

3

32
Q

What HepB serology shows acute infection w/active replication?

A

HBsAg
HBcAg IgM
HBeAg
HBV DNA

33
Q

What is the most important test to run on ascitic fluid?

What indicates SBP?

A

WBC count w/diff

PMN > 250 w/ > 75% white cells

34
Q

What is increased in HBV?

A

Aminotransferases the most

Inc. alk phos and bilirubin

35
Q

What meld score corresponds with class A child-pugh?

A

5-6

36
Q

What is the threshold used to diagnose NAFLD in M and W?

A

M < 20g day

W < 30g day

37
Q

What organisms are most commonly responsible for spontaneous bacterial peritonitis (SBP)?

A

E. coli or Klebsiella

S. Pneumo or viridans, streptococci, enterococcus

38
Q

Autoimmune hepatitis has what serologic markers?

Treatment?

Increased risk for what?

A

+ANA, ASMA, Anti-LKM1

Steroids +/- azathioprine

Cirrhosis and HCC

39
Q

What grade is the following on the hepatic encephalopathy grading scale?

Trivial lack of awareness
Short attention span
Impaired performance of addition
Euphoria or anxiety

A

1

40
Q

What grade is the following on the hepatic encephalopathy grading scale?

Lethargy or apathy
Minimal disorientation for time or place
Subtle personality change 
Inappropriate behavior 
Impaired performance of subtraction
A

2

41
Q

What condition is associated with AMA?

A

PBC

42
Q

What is the #1 and #2 causes of acute liver failure?

What are the leading causes of death?

A

Acetaminophen (tylenol)
Drug reaction

Cerebral edema and sepsis

43
Q

What is seen during the HBV window period?

What else is it called?

A

Anti-HBc IgM

aka HBcAb

44
Q

What amt of drinking puts you at risk of alcoholic cirrhosis?

A

> 50g/day for over 10 years

45
Q

How do you treat acetaminophen (tylenol) OD?

A

N-acetyl-cysteine (NAC) aka Mucomyst

46
Q

What slows progression of chronic HCV?

What genotype has a higher risk for HCC?

A

Coffee

1b

47
Q

What condition is associated with confusion, ataxia, and involuntary abnormal eye movements?

A

Wernicke Encephalopathy

48
Q

OCP use puts pts at risk for what liver condition?

A

Hepatocellular adenoma (benign)

49
Q

Budd chiari can occur in what state?

Is actually what?

Complicated by what?

What does imaging show?

A

Hypercoagulable

Hepatic v. Occlusion

HCC

Prominent caudate lobe

50
Q

What causes a beads on a string pattern?

A

PSC

51
Q

What grade is the following on the hepatic encephalopathy grading scale?

Coma

A

4

GI 2 Final AH (7 decks)

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