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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?

24
Q

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

A

Korsakoff syndrome

25
Pts with a Maddrey DF score above 32 have what? Those with lower scores?
High short-term mortality, tx w/glucocorticoids can help Low short-term mortality, don't need glucocorticoids
26
Formula for SAAG?
Serum albumin - ascitic fluid albumin
27
What does the Glasgow alcoholic hepatitis score predict? Those with a score greater than or equal to 9 had what? Less than 9?
Mortality in alcoholic hepatitis Received glucocorticoids had higher survival rates compared to those who didnt NO survival benefit
28
What do the labs in cirrhosis reveal?
Macrocytic anemia Dec WBC Thrombocytopenia Inc PT time
29
What is the major cause of acute hepatitis in central and SE Asia, Middle East, and North Africa? Spread how?
HEV Swine, waterborne
30
Which child-pugh class has the worst prognosis?
C
31
What grade is the following on the hepatic encephalopathy grading scale? Somnolence to semistupor, responsive to verbal stimuli Confusion Gross disorientation, bizarre behavior
3
32
What HepB serology shows acute infection w/active replication?
HBsAg HBcAg IgM HBeAg HBV DNA
33
What is the most important test to run on ascitic fluid? What indicates SBP?
WBC count w/diff PMN > 250 w/ > 75% white cells
34
What is increased in HBV?
Aminotransferases the most | Inc. alk phos and bilirubin
35
What meld score corresponds with class A child-pugh?
5-6
36
What is the threshold used to diagnose NAFLD in M and W?
M < 20g day | W < 30g day
37
What organisms are most commonly responsible for spontaneous bacterial peritonitis (SBP)?
E. coli or Klebsiella | S. Pneumo or viridans, streptococci, enterococcus
38
Autoimmune hepatitis has what serologic markers? Treatment? Increased risk for what?
+ANA, ASMA, Anti-LKM1 Steroids +/- azathioprine Cirrhosis and HCC
39
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
1
40
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 ```
2
41
What condition is associated with AMA?
PBC
42
What is the #1 and #2 causes of acute liver failure? What are the leading causes of death?
Acetaminophen (tylenol) Drug reaction Cerebral edema and sepsis
43
What is seen during the HBV window period? What else is it called?
Anti-HBc IgM aka HBcAb
44
What amt of drinking puts you at risk of alcoholic cirrhosis?
> 50g/day for over 10 years
45
How do you treat acetaminophen (tylenol) OD?
N-acetyl-cysteine (NAC) aka Mucomyst
46
What slows progression of chronic HCV? What genotype has a higher risk for HCC?
Coffee 1b
47
What condition is associated with confusion, ataxia, and involuntary abnormal eye movements?
Wernicke Encephalopathy
48
OCP use puts pts at risk for what liver condition?
Hepatocellular adenoma (benign)
49
Budd chiari can occur in what state? Is actually what? Complicated by what? What does imaging show?
Hypercoagulable Hepatic v. Occlusion HCC Prominent caudate lobe
50
What causes a beads on a string pattern?
PSC
51
What grade is the following on the hepatic encephalopathy grading scale? Coma
4

GI 2 Final AH (7 decks)

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